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Related Concept Videos

Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

Local Anesthetics: Chemistry and Structure-Activity Relationship

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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...
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Local Anesthetics: Common Agents and Their Applications01:23

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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...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Local Anesthetics: Adverse Effects01:12

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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: Mechanism of Action01:23

Local Anesthetics: Mechanism of Action

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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...
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Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

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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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Psychophysically-anchored, Robust Thresholding in Studying Pain-related Lateralization of Oscillatory Prestimulus Activity
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Tracking local anesthetic effects using a novel perceptual reference approach.

Dominik A Ettlin1, Nenad Lukic1, Jetmir Abazi1

  • 1Center of Dental Medicine, University of Zurich, Zurich, Switzerland;

Journal of Neurophysiology
|January 22, 2016
PubMed
Summary

This study introduces a new perceptual reference method to precisely measure how local anesthetics affect pain perception over time. This approach offers a more accurate way to quantify analgesic drug efficacy compared to traditional pain scales.

Keywords:
analgesia testsanesthesiapainpain assessmentpsychophysics

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Area of Science:

  • Anesthesiology
  • Pain Management
  • Neuroscience

Background:

  • Traditional pain scales rely on subjective magnitude estimation, which can vary significantly between individuals.
  • Existing methods for assessing local anesthetic effects often lack the temporal resolution needed for precise measurement.
  • Unidimensional pain rating scales present challenges in accurately capturing the nuances of sensory perception.

Purpose of the Study:

  • To introduce and validate a novel perceptual reference method for quantifying the effects of local anesthetics.
  • To track subjective sensory perceptions during the onset of an analgesic nerve block with high temporal resolution.
  • To overcome the limitations of conventional experimental pain scales in measuring drug efficacy.

Main Methods:

  • A perceptual reference approach was used with 34 male subjects undergoing a nerve block.
  • Nociceptive electric stimuli were applied to target and reference mandibular canines.
  • Subjects adjusted stimulus intensity on the reference canine to match perceived intensity on the target canine after articaine injection.

Main Results:

  • The novel method allowed for detailed tracking of evolving perceptual changes in response to the analgesic nerve block.
  • Direct and accurate quantification of analgesic effects was achieved with high temporal resolution.
  • The study successfully demonstrated the feasibility of matching sensory experiences across different locations.

Conclusions:

  • The proposed perceptual reference approach offers a more accurate and reliable method for assessing local anesthetic efficacy.
  • This technique facilitates precise measurement of drug effects, overcoming limitations of traditional pain scales.
  • The method is recommended for future experimental investigations of analgesic and anesthetic drug efficacy.