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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...
871
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

501
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...
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Local Anesthetics: Chemistry and Structure-Activity Relationship01:27

Local Anesthetics: Chemistry and Structure-Activity Relationship

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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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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

945
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Local Anesthetics: Mechanism of Action01:23

Local Anesthetics: Mechanism of Action

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Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...
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Related Experiment Video

Updated: Sep 17, 2025

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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Performance of 3 Conversational Generative Artificial Intelligence Models for Computing Maximum Safe Doses of Local

Mélanie Suppan1,2, Pietro Elias Fubini1,2, Alexandra Stefani1,2

  • 1Division of Anaesthesiology, Department of Acute Care Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland.

JMIR AI
|July 3, 2025
PubMed
Summary

Generative AI models like ChatGPT, Copilot, and Gemini are not yet reliable for calculating maximum safe doses of local anesthetics (LAs). Current AI tools demonstrate significant inaccuracies and pose risks, underscoring the need for continued reliance on clinical expertise for safe LA administration.

Keywords:
AIChatGPTCopilotGeminiLALLMMLNLPanesthesiologyanestheticsartificial intelligenceartificial intelligence modelscomparative analysisconversational generative artificial intelligencedose calculationgenerative artificial intelligencelarge language modellocal anestheticmachine learningnatural language processingneural networkperformancetoxicity

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Area of Science:

  • Medical Informatics
  • Anesthesiology
  • Artificial Intelligence in Medicine

Background:

  • Generative artificial intelligence (AI) shows potential for optimizing medical decision-making.
  • Accurate calculation of maximum safe local anesthetic (LA) doses is critical in anesthesiology to prevent local anesthetic systemic toxicity (LAST).
  • Current LA dosing relies on empirical guidelines and clinician experience, leading to variability and errors.

Purpose of the Study:

  • To evaluate the efficacy and safety of three generative AI models (ChatGPT, Copilot, Gemini) in calculating maximum safe LA doses.
  • To determine the potential clinical utility of these AI models for LA dose calculation.

Main Methods:

  • A comparative analysis utilized a 51-item questionnaire across 10 simulated clinical vignettes.
  • AI-generated LA dose calculations were compared against scientifically validated reference doses.
  • Quantitative dose comparisons and qualitative assessments by independent reviewers were performed.

Main Results:

  • All AI models generated responses aligned with LA calculation principles, but safety varied significantly.
  • Gemini often deferred to specialists or provided doses exceeding safe limits by 140% (SD 103%) for mixtures.
  • ChatGPT (90% unsafe, +198% over limit) and Copilot (67% unsafe, +217% over limit) demonstrated poor performance, with qualitative ratings of 'poor'.

Conclusions:

  • Current generative AI models (Gemini, ChatGPT, Copilot) lack the necessary accuracy and reliability for safe LA dose calculation.
  • These AI models should not be used as decision-making tools for LA dosing.
  • Clinicians must continue to rely on expertise and patient assessment for safe LA administration until validated AI solutions emerge.