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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

620
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...
620
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

711
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...
711
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

1.0K
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
1.0K
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

1.0K
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...
1.0K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

598
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...
598
Local Anesthetics: Chemistry and Structure-Activity Relationship01:27

Local Anesthetics: Chemistry and Structure-Activity Relationship

6.1K
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...
6.1K

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Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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[Local anaesthetic systemic toxicity].

Karl Sebastian Johansson, Lotte Christine Groth Høgberg, Mikkel Bring Christensen

  • 1soeren.boegevig.03@regionh.dk.

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|December 15, 2020
PubMed
Summary
This summary is machine-generated.

Local anaesthetic systemic toxicity (LAST) can cause severe central nervous and cardiovascular symptoms. Prompt recognition and treatment, including advanced life support and potentially lipid emulsion, are vital for patient survival.

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Area of Science:

  • Anesthesiology
  • Toxicology
  • Emergency Medicine

Background:

  • Local anaesthetic systemic toxicity (LAST) presents with central nervous system and cardiovascular manifestations.
  • Understanding LAST symptoms and risk factors is essential for effective prevention strategies.
  • Current treatment protocols involve vasopressors, sodium bicarbonate, and advanced life support.

Purpose of the Study:

  • To review the key aspects of local anaesthetic systemic toxicity (LAST).
  • To outline current understanding of LAST symptoms, risk factors, and management.
  • To provide guidance on the appropriate use of interventions like lipid emulsion.

Main Methods:

  • Systematic review of literature on local anaesthetic systemic toxicity.
  • Analysis of reported symptoms, risk factors, and treatment outcomes.
  • Evaluation of current guidelines for managing severe LAST and cardiac arrest.

Main Results:

  • LAST affects both the central nervous and cardiovascular systems.
  • High-quality cardiopulmonary resuscitation (CPR) and prolonged CPR are emphasized in cardiac arrest due to LAST.
  • Extracorporeal life support (ECLS) is a critical consideration for severe LAST cases.

Conclusions:

  • Intravenous lipid emulsion should be reserved for cases where other interventions fail and ECLS is not available.
  • Adherence to advance life support guidelines, including prolonged CPR and ECLS, is crucial for managing LAST-induced cardiac arrest.
  • Continued research and education on LAST are necessary for improved patient outcomes.