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Related Concept Videos

Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

754
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...
754
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

388
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...
388
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

1.0K
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...
1.0K
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

614
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...
614
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

117
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
117
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

428
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...
428

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Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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Pharmacokinetics in regional anesthesia.

André M Leite-Moreira1,2,3, André Correia1, Nuno Vale4,5,6

  • 1Department of Anesthesiology, Unidade Local de Saúde São João.

Current Opinion in Anaesthesiology
|July 16, 2024
PubMed
Summary

Understanding the pharmacokinetics of local anesthetics is crucial for safe regional anesthesia. Novel fascial plane blocks, like the erector spinae plane block, require further study to optimize dosing and prevent toxicity.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Regional Anesthesia

Background:

  • Local anesthetic pharmacokinetics are key determinants of regional anesthesia success and safety.
  • These involve local and systemic distribution phases influencing efficacy and toxicity.
  • Recent research emphasizes novel fascial plane blocks, such as the erector spinae plane block.

Purpose of the Study:

  • To review current research on local anesthetic pharmacokinetics in regional anesthesia.
  • To focus on findings related to various surgical procedures and patient demographics.
  • To highlight the pharmacokinetic considerations for emerging block techniques.

Main Methods:

  • Literature review of recent studies on local anesthetic pharmacokinetics.
  • Analysis of data concerning systemic absorption and local distribution.
  • Examination of pharmacokinetic profiles in different regional block types.

Main Results:

  • Fascial plane blocks, particularly the erector spinae plane block, are a major focus.
  • These blocks often utilize large local anesthetic volumes, exceeding standard doses.
  • Systemic absorption and local kinetics are critical for efficacy and safety.

Conclusions:

  • Fascial plane blocks require extensive pharmacokinetic characterization.
  • Understanding mechanisms and avoiding excessive doses are paramount.
  • Further research on risk factors for systemic toxicity is essential, especially in vulnerable populations like extremes of age and pregnant women.