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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

509
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...
509
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

610
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...
610
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

828
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...
828
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

882
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...
882
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

390
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
390
Stages of General Anesthesia01:22

Stages of General Anesthesia

755
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
755

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Updated: Sep 23, 2025

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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Sudden quadriparesis after non-overdose local anesthesia.

Wei-Chen Chen1, Hsien-Yi Chen1,2, Te-I Weng3,4,5

  • 1Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.

International Journal of Emergency Medicine
|May 17, 2022
PubMed
Summary

A rare case of quadriparesis following lidocaine anesthesia improved with treatment. Intravenous lipid emulsion (ILE) showed promise in reversing these local anesthetic systemic toxicity (LAST) symptoms, suggesting further research is needed.

Keywords:
Lipid emulsionLocal anesthetic systemic toxicityQuadriparesisVocal cord cyst-removal surgery

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Area of Science:

  • Anesthesiology
  • Neurology
  • Toxicology

Background:

  • Lidocaine is a widely used local anesthetic.
  • Local anesthetic systemic toxicity (LAST) can cause severe central nervous system (CNS) and cardiovascular effects.
  • Quadriparesis is a rare but reported adverse event following lidocaine administration.

Purpose of the Study:

  • To report a rare case of quadriparesis after local anesthesia for vocal cord surgery.
  • To discuss the potential mechanism of spinal cord inhibition mimicking anterior cord syndrome.
  • To highlight the efficacy of intravenous lipid emulsion (ILE) in treating such cases.

Main Methods:

  • A case of quadriparesis following local lidocaine administration for vocal cord cyst-removal surgery was reported.
  • The patient's symptoms dramatically improved after treatment.
  • The potential mechanism of local lidocaine diffusion to the spinal cord was considered.

Main Results:

  • The patient experienced quadriparesis after lidocaine local anesthesia.
  • Treatment with intravenous lipid emulsion (ILE) led to a favorable outcome and significant improvement.
  • The case suggests ILE can be effective for non-overdose local anesthetic-induced spinal cord inhibition.

Conclusions:

  • Intravenous lipid emulsion (ILE) can be effective in reversing spinal cord inhibition symptoms caused by local anesthetics.
  • This case underscores the importance of considering ILE for managing rare adverse effects of local anesthetics like lidocaine.
  • Further research is warranted to explore the role of ILE in treating LAST and other local anesthetic-induced toxicities.