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

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

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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: 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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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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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...
571
Local Anesthetics: Chemistry and Structure-Activity Relationship01:27

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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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Updated: Nov 9, 2025

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[Liposuction with consequences: what to consider when using prilocaine].

Julius Michael Mayer1, Carl Ferdinand Capellen2, Thomas Holzbach1

  • 1Spital Thurgau AG, Hand- und Plastische Chirurgie.

Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|April 16, 2021
PubMed
Summary
This summary is machine-generated.

Prilocaine, a local anesthetic, can rarely cause methaemoglobinaemia, a dangerous condition. This case report details a patient who developed this complication after liposuction, emphasizing the need for awareness among emergency personnel.

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Area of Science:

  • Anesthesiology
  • Toxicology
  • Emergency Medicine

Background:

  • Prilocaine is a commonly used local anesthetic.
  • Methaemoglobinaemia is a rare condition characterized by elevated levels of methemoglobin.
  • Acquired methaemoglobinaemia can be induced by certain drugs, including prilocaine.

Purpose of the Study:

  • To report a case of prilocaine-induced methaemoglobinaemia following liposuction.
  • To highlight a potentially dangerous complication of regional anesthesia with prilocaine.
  • To raise awareness among healthcare professionals regarding this rare adverse event.

Main Methods:

  • A case report of a young female patient presenting to the Emergency Department.
  • Review of patient's medical history, including recent outpatient liposuction with regional anesthesia.
  • Clinical examination, arterial blood gas analysis, and conventional radiography.
  • Oxygen therapy and supportive care.

Main Results:

  • The patient developed cyanosis, hypoxia, and significantly elevated methaemoglobin levels (10.9%) post-liposuction.
  • Methaemoglobin levels decreased to 6% after oxygen therapy, with stabilization of vital signs.
  • The patient also sustained a distal radius fracture and chin laceration, which were managed concurrently.

Conclusions:

  • Prilocaine-induced methaemoglobinaemia is a rare but serious complication that can occur after procedures involving prilocaine, such as liposuction.
  • Prompt recognition and management, including oxygen therapy, are crucial for patient recovery.
  • Increased vigilance and discussion regarding prilocaine use are warranted in emergency and surgical settings.