This document discusses local anaesthetic agents. It defines local anaesthetics as compounds that produce temporary neural blockade. It describes the history of local anaesthetics from cocaine in the 19th century to modern synthetic derivatives. It outlines the ideal properties of local anaesthetics and classifications such as ester vs amide groups and duration of action. The document discusses the structure, mechanisms of action, pharmacokinetics, toxicity and management of toxicity of local anaesthetic agents. It also covers adjuvants that are added to local anaesthetics to modify their effects.
Classification
Mechanism of action
Duration of action
Absorption and distribution
Mode of action
Theories of action of L.A
Pharmacokinetics of local anaesthetics
Routes of administration
Metabolism or biotransformation
Individual agents
Vasoconstrictors
Systemic effects
Toxicity
Advantages
Disadvantages
Maximum allowable dose
Local anaesthetics in community trust services
Classification
Mechanism of action
Duration of action
Absorption and distribution
Mode of action
Theories of action of L.A
Pharmacokinetics of local anaesthetics
Routes of administration
Metabolism or biotransformation
Individual agents
Vasoconstrictors
Systemic effects
Toxicity
Advantages
Disadvantages
Maximum allowable dose
Local anaesthetics in community trust services
It remains the responsibility of all clinicians using LA
to understand their potential
for severe systemic toxicity and to be prepared to respond immediately to these events when they occur.
A teaching slide set describing the mechanisms of action and clinical use of local anaesthetics. This session is a basic introduction to the pharmacodynamics and pharmacokinetics of local anaesthetics. It is aimed at preclinical medical or dental students, or students in the early years of a pharmacology degree.
local anaesthesia is defined as a loss of sensation in a circumscribed area of the body caused by a depression of excitation in nerve endings
Or an inhibition of the conduction process in peripheral nerves; no loss of consciousness occurs
Local anesthetics interfere with the excitation process in the nerve membrane in one or more of the following ways:
1) Altering the basic resting potential of the nerve membrane
2) Altering the threshold potential (firing level)
3) Decreasing the rate of depolarization*
4) Prolonging the rate of repolarization
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
Local anesthesia, all in one place with all the references and all the important points.
It contains some videos and animations, for which feel free to contact. As such animations are not compatible with Slideshare. Enjoy and please hit the like button if you liked the presentation.
Pain is the common symptom in many chronic conditions such as cancers, neuropathies, and chronic disease. It is also experienced in trauma varying from mild to severe based on the location and degree of trauma. This presentation is a brief outline on types of pain, classification of pain, pain pathways and management of pain
It remains the responsibility of all clinicians using LA
to understand their potential
for severe systemic toxicity and to be prepared to respond immediately to these events when they occur.
A teaching slide set describing the mechanisms of action and clinical use of local anaesthetics. This session is a basic introduction to the pharmacodynamics and pharmacokinetics of local anaesthetics. It is aimed at preclinical medical or dental students, or students in the early years of a pharmacology degree.
local anaesthesia is defined as a loss of sensation in a circumscribed area of the body caused by a depression of excitation in nerve endings
Or an inhibition of the conduction process in peripheral nerves; no loss of consciousness occurs
Local anesthetics interfere with the excitation process in the nerve membrane in one or more of the following ways:
1) Altering the basic resting potential of the nerve membrane
2) Altering the threshold potential (firing level)
3) Decreasing the rate of depolarization*
4) Prolonging the rate of repolarization
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
Local anesthesia, all in one place with all the references and all the important points.
It contains some videos and animations, for which feel free to contact. As such animations are not compatible with Slideshare. Enjoy and please hit the like button if you liked the presentation.
Pain is the common symptom in many chronic conditions such as cancers, neuropathies, and chronic disease. It is also experienced in trauma varying from mild to severe based on the location and degree of trauma. This presentation is a brief outline on types of pain, classification of pain, pain pathways and management of pain
Local anesthesia has been defined as loss of sensation in a circumscribed area of the body caused by depression of excitation in nerve endings or inhibition of the conduction process in peripheral nerves.
Local anesthesia in dentistry /certified fixed orthodontic courses by Indian...Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
2. DEFINITION
Local Anaesthetics or analgesics are the
compounds that produce temporary blockade of
neural transmission when applied to the vicinity of
nerve and all excitable tissues including
myocardium.
Analgesia- loss of pain sensation using lower
concentration of Local Anaesthetics.( Aδ & C fibre
only)
Anaesthesia-Loss of all sensation by higher
concentration of local Anaesthetics(all fibres are
blocked)
3. HISTORY
Cocaine- from plant “Coca”in South America in
nineteenth century.
Karl Koller of Vienna first discovered the
advantages of cocaine,used it as a topical
opthalmic anaesthetic in 1884
Today’s local anaestetics are synthetic chemical
descedants of cocaine.
In 1944,lignocaine,the first amide linkage local
anaesthetic was introduced in Sweden.
4. IDEAL PROPERTIES OF LOCAL ANAESTHETICS
It should not be irritating to the tissue to which it is
applied.
Must be water soluble.
Sterilisable by heat.
Rapid onset of action.
Duration of action appropriate to the operation to be
performed.
Should be non-toxic.
Leave no local after effects e.g.: Necrosis.
5. CLASSIFICATION
According to nature of linkage between amine and arometic
parts into ester or amide group:
1)Ester:
a)Chloroprocaine
b)Cocaine
c)Procaine
d)Tetracaine
7. According to duration of action:
a)Short acting:(30-60 minutes)
a)Chloroprocaine
b)Procaine
b)Intermadiate acting:(60-120 minutes)
a)Lignocaine
b)Mepivacaine
c)Prilocaine
c)Long acting:(>120 minutes)
a)Bupivacaine
b)Ropivacaine
8. STRUCTURE OF LOCAL ANAESTHETIC
o Local Anaesthetics are weak bases of
a tertiary amine.They have three
functional units-
1)Lipophilic,aromatic part
2)Hydrophillic
3)Ester or amide linkage
9. o They are classified according to
their linkage chain- Esters and Amide
group.
o LA are prepared as water soluble salt of
any acid usually hydrochloride.In the
multi dose vial it contains antifungal
agents like Na-metabisulfate.
10. MECHANISM OF LOCAL ANESTHETICS
Local anaesthetic agent (LA) __ (PH approximately 6)
In tissue, PH increase, Dissociates to release free base.
Free base is lipid soluble.
Enter into the interior of the axon.
Re-ionization takes place.
Re-ionized portion block the Na+ channel and prevent
influx of sodium ions.
11. Fails to initiation and propagation of action potential.
Impulse cannot go to the Higher centre.
No pain sensation.
12. MECHANISM OF ACTION OF LA
ionized
ionized unionized Enters into
cell
ionization
unionized
14. FACTORS INFLUENCING ACTIVITY
Molecular weight:
Molecular weight Lipid Solubility duration of
action of local anaesthetic agents.
Lipid solubility:
lipid solubility onset and duration of action of
local anaesthetic agents.
15. pKa:
pKa degree of ionisation rapid onset of block
pH :
pH degree of ionisation amount of drug
available to cross neuronal membrane potency
18. ABSORPTION
Absorption from different site is influenced by blood flow to
tissue and the uptake of drug into vascular compartment.
Sequence:
Intercoastal>caudal>Epidural>Plexus>Peripheral>Subcutaneous
19. METABOLISM
Ester local anaesthetics are metabolized by plasma
cholinesterase.
Amide local anaesthetics are metabolized by Liver.
20. TOXICITY FROM LOCAL ANAESTHETIC DRUGS
o Toxic side effects of Local anaesthetic drugs occur
when excessive blood levels is achieved.This is
usually due to-
o Accidental rapid intravenous infusion.
o Rapid absorption,such as from a very vascular site
i.e mucous membrane.
o Absolute overdose if the dose used is excessive
21. LOCAL ANAESTHETIC TOXICITY
A) Central nervous system toxicity:
1) Early symptoms:
a) Circumoral numbness.
b) Tongue Paresthesia.
c) Dizziness.
2) Sensory complain:
a) Tinnitus.
b) Blurred vision
22. 3) Excitatory:
a) Restlessness.
b) Agitation.
c) Nervousness.
4) CNS depression:
a) Slurred speech.
b) Drowsiness.
c) Unconsciousness.
d) Convulsion
25. FACTORS AFFECTING LA TOXICITY
1) Quantity of drug:
Increase quantity of drug Increase toxicity.
2) Concentration of drug:
Increase concentration of drug Increase
toxicity.
3) Absence of adrenalin:
Absence of adrenalin Increase toxicity.
4) Vascularity of the area:
Increase Vascularity of drug Increase toxicity.
26. 5) Rate of absorption:
Increase absorption of drug Increase toxicity
6) Rate of distribution of drug:
Increase distribution of drug Increase toxicity.
7) Rate of metabolism:
Increase metabolism of drug Increase toxicity.
8) Rate of protein binding:
Increase protein binding of drug Decrease
toxicity.
27. REDUCING THE RISK OF TOXICITY
Decide on the conc. of the local anaesthetic that is
required for the block to be performed.
Use the least toxic drug available.
Use lower doses in frail patients or at the extremes
of age.
28. Always inject the and aspirate regularly looking for
blood to indicate an accidental intravenous
injection.
Injection of test dose of 2-3 ml of LA containing
adrenaline will often cause a significant tachycardia
if accidental intravenous injection occurs .
29. Most Nerve blocks are dependent on volume of
drug injected than total dose.Therefore if more
volume is needed it is better dilute the local
anaesthetic with 0.9% saline than to add more local
anaesthetic and increase the dose unneccesarily.
30. Add adrenaline to reduce the speed of
absorption.The addition of adrenaline will reduce
the maximum blood conc. By about 50%.The
addition of adrenaline will make no difference to the
toxicity of LA if it is injected intravenously.
33. ADJUVANTS
Varietes of agents are added to LA to modify the effects
in clinical practice.These are-
Epinephrine:is added to LA to-
a)Prolong the anaesthetic effect by decreasing
absorption from site of conjugation
b)Improve the quality and reliability of central neural
blockade.
c)Decrease systemic toxicity.
34. Opioids:all narcotics prolong the duration of action
Hyaluronidase: allows greater spread of solution
along tissue plan thereby spread the onset of action
Alkalinization: alkalinization of LA is used to speed
the onset of action
35. Dextran:Dextran added to LA to increase duration
of action.
Carbonation: addition of carbonic acid to LA
reduces the onset time and duration of action
α-agonist: are used to prolong and potentiate the
effect of LA in all central neuraxial block.
36. Other Agents used: mostly for epidural and SAB.
-Ketamine
-Neostigmine
-Midazolam
37. CONCLUSION
Any unusual cardiovascular or neurological
signs,including outright cardiac arrest,after local
anaesthetic adminitration should rise suspicion of
LA systemic toxicity(LAST)
The risk of LA systemic toxicity(LAST) is influenced
by patient factors,the site and conduct of the
block,and the LA type and dose.
38. Education of anaesthesist and non-anaesthesists in
LAST management should improve patient safety.
AAGBI guidelines aid emergency management of
LAST.