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Related Concept Videos

Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

1.5K
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

Local Anesthetics: Chemistry and Structure-Activity Relationship

7.2K
Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...
7.2K
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

1.2K
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
1.2K
Local Anesthetics: Mechanism of Action01:23

Local Anesthetics: Mechanism of Action

4.4K
Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...
4.4K
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

2.0K
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
2.0K

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Local Anesthesia Toxicity and Lipid Rescue.

Kim A Noble

    Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
    |July 27, 2015
    PubMed
    Summary
    This summary is machine-generated.

    Local anesthesia systemic toxicity (LAST) is a rare but severe complication. Lipid emulsion therapy is an emerging treatment, and perianesthesia nurses play a key role in managing patients experiencing LAST.

    Keywords:
    LASTlipid emulsion rescuelocal anesthesia toxicity

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    Area of Science:

    • Anesthesiology
    • Emergency Medicine
    • Nursing

    Background:

    • Regional anesthesia has been used for surgical pain control since the late 1880s.
    • Local anesthesia systemic toxicity (LAST) is a rare, life-threatening complication of regional anesthesia.
    • Lipid emulsion therapy has shown promise in treating LAST in animal and human studies.

    Purpose of the Study:

    • To review the role of perianesthesia nurses in managing LAST.
    • To present evidence-based recommendations for LAST prevention, monitoring, and treatment.
    • To discuss the pharmacologic characteristics of local anesthetics and sensory conduction.

    Main Methods:

    • A fictitious case study of a patient with LAST is used to illustrate concepts.
    • Pharmacologic characteristics of local anesthetics are reviewed.
    • Evidence-based practice recommendations are provided.

    Main Results:

    • Lipid emulsion therapy has demonstrated successful outcomes in human case reports for LAST.
    • Perianesthesia nurses are crucial for patient assessment, communication, and emergent management of LAST.
    • Understanding local anesthetic pharmacology is essential for prevention and treatment.

    Conclusions:

    • Lipid emulsion therapy is a vital treatment for local anesthesia systemic toxicity.
    • Perianesthesia nurses require specific knowledge and skills to manage LAST effectively.
    • Comprehensive strategies for prevention, monitoring, and treatment of LAST are essential.