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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

388
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...
388
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

359
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...
359
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

731
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...
731
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

582
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...
582
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

404
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...
404
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

411
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...
411

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ED Regional Anesthesia Practice and the Basics on Local Anesthesia Toxicity.

B J Olsen1

  • 1Author Affiliation: Department of Endoscopy, Royal Victoria Hospital, Belfast, United Kingdom.

Advanced Emergency Nursing Journal
|December 6, 2024
PubMed
Summary

Emergency nurses must recognize local anesthetic toxicity (LAT), a potential complication of nerve blocks for fractures. This article provides UK guidelines for identifying and treating LAT, differentiating it from anaphylaxis.

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Area of Science:

  • Emergency Medicine
  • Anesthesiology
  • Nursing Practice

Background:

  • Nerve blocks are commonly used in Emergency Departments in the US and UK for fracture management.
  • Emergency nurses play a crucial role in patient care during orthopedic surgery wait times.
  • Local anesthetic toxicity (LAT) is a significant adverse event associated with nerve blocks.

Purpose of the Study:

  • To raise awareness among emergency nurses regarding local anesthetic toxicity (LAT).
  • To provide a knowledge base for identifying and treating LAT based on UK protocols.
  • To highlight the symptomatic similarities between LAT and anaphylaxis.

Main Methods:

  • Review of existing UK protocols and guidelines for managing local anesthetic toxicity.
  • Discussion of clinical presentations of LAT.
  • Comparative analysis of symptoms of LAT and anaphylaxis.

Main Results:

  • UK protocols offer a structured approach to identifying and treating LAT.
  • Early recognition and intervention are critical for managing LAT.
  • Distinguishing LAT from anaphylaxis is essential for appropriate treatment.

Conclusions:

  • Emergency nurses require education on recognizing and managing LAT.
  • Adherence to established protocols improves patient outcomes for LAT.
  • Understanding symptom overlap with anaphylaxis enhances diagnostic accuracy.