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Related Concept Videos

Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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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: 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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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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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: 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: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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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.
One of the advantages of...
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Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
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Effect of Topical Anesthesia Using an Adhesive Patch and Anesthetic Solution.

Toshiyuki Kishimoto1, Nobuyuki Matsuura2, Masataka Kasahara3

  • 1Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Mihama-ku, Chiba-shi, Japan.

Anesthesia Progress
|June 13, 2017
PubMed
Summary

Lidocaine with epinephrine demonstrated potent topical anesthetic effects comparable to benzocaine. This amide local anesthetic effectively reduced trigeminal somatosensory evoked potential amplitudes, indicating significant efficacy for topical anesthesia.

Keywords:
Adhesive patchBenzocaineLidocainePainSomatosensory evoked potential

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Dentistry

Background:

  • Topical anesthetics are crucial in dental procedures.
  • Amide and ester local anesthetics have different properties.
  • Investigating lidocaine's efficacy as a topical anesthetic is important.

Purpose of the Study:

  • To evaluate the efficacy of 2% lidocaine hydrochloride with epinephrine as a topical anesthetic on alveolar mucosa.
  • To compare the anesthetic effect of lidocaine with benzocaine and a saline control.

Main Methods:

  • Trigeminal somatosensory evoked potentials (TSEP) were recorded in 18 healthy volunteers.
  • A hemostatic adhesive patch with lidocaine, benzocaine, or saline was applied to the maxillary right canine alveolar mucosa for 5 minutes.
  • Electrical stimulation was used to elicit TSEP, with recordings taken after patch removal.

Main Results:

  • Lidocaine treatment significantly decreased the N100-P125 amplitude of TSEP immediately, 5, and 10 minutes post-application.
  • The reduction in TSEP amplitude by lidocaine was comparable to that of benzocaine.
  • Benzocaine and lidocaine showed greater effects than the saline control.

Conclusions:

  • Amide local anesthetics, like lidocaine with epinephrine, can provide potent topical anesthesia.
  • Lidocaine's topical anesthetic effect on alveolar mucosa is comparable to ester anesthetics such as benzocaine.
  • TSEP is a viable method for assessing topical anesthetic efficacy.