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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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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.
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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.
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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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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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Clinically Enhancing Local Anesthesia Techniques for Endodontic Treatment.

James Bahcall1, Qian Xie2

  • 1Clinical Associate Professor, Department of Endodontics, University of Illinois-Chicago School of Dentistry, Chicago, Illinois; Diplomate, American Board of Endodontics.

Compendium of Continuing Education in Dentistry (Jamesburg, N.J. : 1995)
|February 4, 2017
PubMed
Summary

Achieving profound pulpal anesthesia during endodontic treatment requires understanding local anesthetic mechanisms and objective testing. Clinicians must integrate supplemental anesthesia when needed for effective pain control.

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Area of Science:

  • Dentistry
  • Anesthesiology

Background:

  • Local anesthesia is crucial for endodontic treatment.
  • Clinicians often overlook local anesthetics as drugs, impacting efficacy.
  • Consistent profound pulpal anesthesia remains a clinical challenge.

Purpose of the Study:

  • To emphasize the importance of understanding local anesthetic pharmacology in endodontics.
  • To guide clinicians in achieving profound pulpal anesthesia.
  • To highlight objective assessment and supplemental anesthesia techniques.

Main Methods:

  • Review of local anesthetic mechanisms of action.
  • Discussion of objective clinical signs for assessing pulpal anesthesia.
  • Integration of supplemental anesthesia strategies.

Main Results:

  • Understanding the local anesthetic process is key to clinical success.
  • Objective testing provides reliable assessment of pulpal anesthesia.
  • Supplemental anesthesia is often necessary for complete pulpal anesthesia.

Conclusions:

  • Clinicians must treat local anesthetics as drugs to optimize their use.
  • Thorough understanding and objective testing improve anesthesia outcomes.
  • Strategic use of supplemental anesthesia enhances endodontic treatment effectiveness.