Systemic effects of LOCAL ANESTHESIA
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Local anesthetics can have systemic effects at high levels. They primarily act by depressing the central nervous system and lowering seizure thresholds. Preconvulsive signs may include numbness, shivering, or twitching. Convulsions last less than a minute and increase blood flow and metabolism. Local anesthetics have direct effects on the cardiovascular and respiratory systems by relaxing muscles and decreasing heart rate and blood pressure. Toxicity is caused by rapid intravenous injection, absorption from vascular sites, or overdose. Factors reducing toxicity include using the minimum effective dose and concentration and slowly injecting while aspirating.
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"LOCAL-ANAESTHESIA"
This document provides an overview of local anaesthesia including:
- A definition and historical background of local anaesthetics such as cocaine and procaine.
- Desirable properties and classifications of local anaesthetics.
- Details on common local anaesthetics like lidocaine including mechanism of action, dosage, and comparisons to other agents.
- Factors to consider in selecting a local anaesthetic for a patient and important information to obtain from the patient.
- Techniques for administering local anaesthesia and managing complications.
Local anesthetics,drugs, doses,theories, mechanisms
Local anesthesia is a transient loss of sensation in a localized area caused by blocking nerve conduction without loss of consciousness. It works by binding to receptor sites on nerve membranes and blocking sodium channels, preventing the transmission of nerve impulses. Common local anesthetics are lidocaine, prilocaine, mepivacaine and bupivacaine. Vasoconstrictors like epinephrine are often added to prolong the effects and reduce systemic absorption. Proper dosage calculation and contraindications must be considered for safe administration of local anesthesia.
Local anaesthesia _pedo_
This document discusses various techniques for achieving local anesthesia in dental procedures. It describes common methods such as local infiltration, field block, nerve block, intraligamentary injection, intraseptal injection, intrapulpal injection, intraosseous injection, jet injection, computer-controlled local anesthetic delivery systems, and electronic dental anesthesia. It also discusses topical anesthesia and provides details on the principles, indications, contraindications, advantages and disadvantages of each technique. The goal is to outline options for effectively achieving anesthesia for different dental treatments and patient situations.
Local anesthesia ppt
This document provides information on various techniques for local anesthesia in dentistry. It discusses the mechanism of action, classifications, and maximum recommended doses of local anesthetics. It also describes in detail techniques for maxillary injections including inferior alveolar nerve block, Gow Gates, and Vazirani Akinosi techniques for mandibular anesthesia. Complications and contraindications of local anesthesia are mentioned.
Concious Sedation
This document provides information on conscious sedation techniques for pediatric dental patients. It defines conscious sedation and describes the different levels of sedation from minimum to general anesthesia. Common agents used for sedation like nitrous oxide, sevoflurane and midazolam are discussed along with their indications, benefits and limitations. Requirements for providing safe sedation like pre-sedation assessment, monitoring equipment and recovery are outlined. Inhalation sedation using nitrous oxide and oxygen is described in detail including administration techniques and planes of sedation. The document concludes by listing some references.
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This document discusses various local anesthesia techniques used in dentistry. It begins by introducing regional anesthesia techniques like field blocks, nerve blocks, and local infiltration. It then describes specific injection techniques for the maxilla including posterior superior alveolar nerve blocks, middle superior alveolar nerve blocks, anterior superior alveolar/infraorbital nerve blocks, nasopalatine nerve blocks, greater palatine nerve blocks, and maxillary nerve blocks. Mandibular injection techniques discussed include inferior alveolar nerve blocks and mental nerve blocks. The document provides details on appropriate needle size, insertion points, depths, and areas anesthetized for each technique.
Local anesthesia
Local anesthesia is defined as a transient reversible loss of sensation caused by blocking nerve conduction in a localized area. There are two types of local anesthetics: amides and esters. Amides such as lidocaine are preferred due to their longer duration of action and lower risk of allergic reactions. Local anesthetic solutions also contain vasoconstrictors to prolong the effects and buffering agents. The document discusses the mechanisms, uses, contraindications and toxicity of local anesthesia in detail. It provides classifications based on duration and vasoconstrictor types used. Potential adverse effects on the central nervous system, cardiovascular system and risks of methemoglobinemia are outlined.
Maximum recommended doses LOCAL ANAESTHESIA
This document discusses maximum safe doses of local anesthetics used in dental procedures. It notes that doses are typically measured in milligrams per kilogram or milligrams per pound of body weight, but there is variability in patient responses. For most patients, staying within the maximum recommended dose based on weight should avoid overdose reactions. However, smaller or older patients may be at higher risk and require lower doses. The document recommends always using the smallest effective dose to minimize risks, especially for those with medical compromises. It provides a table comparing maximum recommended dosages of common local anesthetics.
Recommended
"LOCAL-ANAESTHESIA"
This document provides an overview of local anaesthesia including:
- A definition and historical background of local anaesthetics such as cocaine and procaine.
- Desirable properties and classifications of local anaesthetics.
- Details on common local anaesthetics like lidocaine including mechanism of action, dosage, and comparisons to other agents.
- Factors to consider in selecting a local anaesthetic for a patient and important information to obtain from the patient.
- Techniques for administering local anaesthesia and managing complications.
Local anesthetics,drugs, doses,theories, mechanisms
Local anesthesia is a transient loss of sensation in a localized area caused by blocking nerve conduction without loss of consciousness. It works by binding to receptor sites on nerve membranes and blocking sodium channels, preventing the transmission of nerve impulses. Common local anesthetics are lidocaine, prilocaine, mepivacaine and bupivacaine. Vasoconstrictors like epinephrine are often added to prolong the effects and reduce systemic absorption. Proper dosage calculation and contraindications must be considered for safe administration of local anesthesia.
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This document provides information on various techniques for local anesthesia in dentistry. It discusses the mechanism of action, classifications, and maximum recommended doses of local anesthetics. It also describes in detail techniques for maxillary injections including inferior alveolar nerve block, Gow Gates, and Vazirani Akinosi techniques for mandibular anesthesia. Complications and contraindications of local anesthesia are mentioned.
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This document provides information on conscious sedation techniques for pediatric dental patients. It defines conscious sedation and describes the different levels of sedation from minimum to general anesthesia. Common agents used for sedation like nitrous oxide, sevoflurane and midazolam are discussed along with their indications, benefits and limitations. Requirements for providing safe sedation like pre-sedation assessment, monitoring equipment and recovery are outlined. Inhalation sedation using nitrous oxide and oxygen is described in detail including administration techniques and planes of sedation. The document concludes by listing some references.
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This document discusses various local anesthesia techniques used in dentistry. It begins by introducing regional anesthesia techniques like field blocks, nerve blocks, and local infiltration. It then describes specific injection techniques for the maxilla including posterior superior alveolar nerve blocks, middle superior alveolar nerve blocks, anterior superior alveolar/infraorbital nerve blocks, nasopalatine nerve blocks, greater palatine nerve blocks, and maxillary nerve blocks. Mandibular injection techniques discussed include inferior alveolar nerve blocks and mental nerve blocks. The document provides details on appropriate needle size, insertion points, depths, and areas anesthetized for each technique.
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Local anesthesia is defined as a transient reversible loss of sensation caused by blocking nerve conduction in a localized area. There are two types of local anesthetics: amides and esters. Amides such as lidocaine are preferred due to their longer duration of action and lower risk of allergic reactions. Local anesthetic solutions also contain vasoconstrictors to prolong the effects and buffering agents. The document discusses the mechanisms, uses, contraindications and toxicity of local anesthesia in detail. It provides classifications based on duration and vasoconstrictor types used. Potential adverse effects on the central nervous system, cardiovascular system and risks of methemoglobinemia are outlined.
Maximum recommended doses LOCAL ANAESTHESIA
This document discusses maximum safe doses of local anesthetics used in dental procedures. It notes that doses are typically measured in milligrams per kilogram or milligrams per pound of body weight, but there is variability in patient responses. For most patients, staying within the maximum recommended dose based on weight should avoid overdose reactions. However, smaller or older patients may be at higher risk and require lower doses. The document recommends always using the smallest effective dose to minimize risks, especially for those with medical compromises. It provides a table comparing maximum recommended dosages of common local anesthetics.
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This document provides information on various techniques of local anesthesia. It begins by classifying local anesthesia techniques into topical, infiltration, and nerve block. For infiltration anesthesia, it describes soft tissue and intra-bony infiltration techniques for the maxilla and mandible. For nerve block anesthesia, it details techniques for blocking specific nerves of the maxilla like the posterior superior alveolar nerve and mandible like the inferior alveolar nerve. Factors influencing choice of technique and contraindications are also summarized. The document provides in-depth descriptions of performing local anesthesia techniques for the maxilla and mandible.
Local Anaesthetics
- Local anesthetics are drugs that cause reversible loss of sensation, especially pain, in a localized area of the body when applied topically or injected locally. They block the generation and conduction of nerve impulses at the site of contact without damaging neurons.
- Common uses include dentistry, excision procedures, dermatology, and spinal or regional anesthesia. Local anesthetics work by inhibiting sodium influx through voltage-gated sodium channels in neurons, interrupting action potential generation and signal conduction.
- Examples of side effects include central nervous system stimulation or depression in high doses, cardiovascular effects like arrhythmias and hypotension, and hypersensitivity reactions.
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This document provides information on local anesthesia. It begins with definitions and history, describing how local anesthesia was developed by Koller in 1884 using procaine. It then discusses the various methods of inducing local anesthesia and the neuroanatomy and electrophysiology of nerve conduction. The remainder of the document focuses on the pharmacology of local anesthetics, including theories of action, properties, classification, pharmacokinetics, composition, and maximum permissible doses. Specific local anesthetic techniques for the maxilla and mandible are also outlined.
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Local anaesthesia
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The document discusses local anesthetics, including their definition, requirements, mechanisms of action, classifications, and biotransformation. It notes that local anesthetics work by inhibiting sodium influx through voltage-gated sodium channels in neuronal cells, blocking nerve conduction. Local anesthetics are classified based on duration of action, chemical nature, and origin. Common examples are discussed and appropriate uses along with potential complications and contraindications are outlined.
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This document outlines local and systemic complications that can occur from dental injections. It discusses various local complications including paresthesia, needle breakage, hematoma, pain on injection, facial nerve paralysis, infection, trismus, soft tissue injury, and edema. It also discusses rare ocular complications that can occur from inadvertent injection into blood vessels supplying the eye. Prevention and management strategies are provided for each complication. Systemic complications from overdose or allergy are also briefly covered. Predisposing factors that can increase risks of complications are outlined.
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Local anesthesia produces loss of sensation in a specific area without loss of consciousness. It is commonly used in dentistry for procedures like tooth extractions, fillings, and surgery to relieve pain. Local anesthetics work by depressing nerve conduction, preventing the generation and conduction of nerve impulses. They are contraindicated in patients with certain medical conditions like infections, liver or kidney disease, or cardiac issues.
Recent advances in Local anesthesia
This document summarizes recent advances in local anesthesia for dentistry. It discusses newer local anesthetic drugs like articaine and centbucridine that are equally or more effective than lignocaine. It also describes new delivery systems for local anesthesia like computer-controlled local anesthesia delivery systems, jet injectors, and iontophoresis that reduce injection pain and improve patient comfort. Devices like CCLADs allow controlled infusion of anesthetic for more precise needle insertion and placement.
PHARMACOLOGY OF LOCAL ANESTHESIA
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
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This document summarizes vasoconstrictors which are drugs that constrict blood vessels and control tissue perfusion. It is added to local anesthetics (LA) to oppose their vasodilatory effects. Vasoconstrictors are classified as catecholamines like epinephrine and norepinephrine or noncatecholamines. They can act directly, indirectly, or mixed on receptors like alpha, beta 1,2,3 receptors. The maximum recommended doses for epinephrine are provided for healthy and cardiac patients. Dilutions of vasoconstrictors from 1:1000 to 1:200,000 are explained. The document also compares epinephrine and norepinephrine.
Local anesthesia
This document discusses local anesthesia and pain control techniques for pediatric dentistry. It defines pain and anesthesia and covers various local anesthesia techniques including topical anesthesia, infiltration, nerve blocks, and supplemental injection techniques. It provides details on the contents of local anesthesia carpules, how local anesthetics are metabolized in the body, recommended dosages, and complications. The goal is to effectively manage pain for dental procedures in children.
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This document provides information on general anesthesia, local anesthesia, and conscious sedation including:
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- The American Society of Anesthesiologists patient physical status classification system.
- The stages of general anesthesia according to Guedel and Gillespie.
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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.
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Local anaesthetics cause reversible loss of sensation in a specific area by altering the functioning of nerve cells. They are absorbed and distributed throughout the body after administration but only cause anaesthesia locally due to their ability to selectively affect nerve cells. Local anaesthetics are metabolized in the liver and excreted by the kidneys, and have the potential for toxicity if blood levels become too high, which can lead to seizures, respiratory depression, hypotension, and other adverse effects.
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This document provides information on various techniques of local anesthesia. It begins by classifying local anesthesia techniques into topical, infiltration, and nerve block. For infiltration anesthesia, it describes soft tissue and intra-bony infiltration techniques for the maxilla and mandible. For nerve block anesthesia, it details techniques for blocking specific nerves of the maxilla like the posterior superior alveolar nerve and mandible like the inferior alveolar nerve. Factors influencing choice of technique and contraindications are also summarized. The document provides in-depth descriptions of performing local anesthesia techniques for the maxilla and mandible.
Local Anaesthetics
- Local anesthetics are drugs that cause reversible loss of sensation, especially pain, in a localized area of the body when applied topically or injected locally. They block the generation and conduction of nerve impulses at the site of contact without damaging neurons.
- Common uses include dentistry, excision procedures, dermatology, and spinal or regional anesthesia. Local anesthetics work by inhibiting sodium influx through voltage-gated sodium channels in neurons, interrupting action potential generation and signal conduction.
- Examples of side effects include central nervous system stimulation or depression in high doses, cardiovascular effects like arrhythmias and hypotension, and hypersensitivity reactions.
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This document provides information on local anesthesia. It begins with definitions and history, describing how local anesthesia was developed by Koller in 1884 using procaine. It then discusses the various methods of inducing local anesthesia and the neuroanatomy and electrophysiology of nerve conduction. The remainder of the document focuses on the pharmacology of local anesthetics, including theories of action, properties, classification, pharmacokinetics, composition, and maximum permissible doses. Specific local anesthetic techniques for the maxilla and mandible are also outlined.
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This document provides an overview of the pharmacology of local anesthetics (LA). It discusses the uptake, distribution, metabolism, and excretion of LAs. Specific LAs like lidocaine, mepivacaine, and bupivacaine are examined in terms of their potency, toxicity, onset of action, and maximum safe doses. The systemic effects of LAs on the central nervous system, cardiovascular system, and respiratory system are reviewed. The importance of adding vasoconstrictors to LA solutions to decrease blood flow and increase drug concentration at the injection site is highlighted. Factors in selecting appropriate vasoconstrictors are also considered.
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The document discusses local anesthetics, including their definition, requirements, mechanisms of action, classifications, and biotransformation. It notes that local anesthetics work by inhibiting sodium influx through voltage-gated sodium channels in neuronal cells, blocking nerve conduction. Local anesthetics are classified based on duration of action, chemical nature, and origin. Common examples are discussed and appropriate uses along with potential complications and contraindications are outlined.
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Local anesthesia complications can be divided into those associated with absorption of the anesthetic solution and those associated with needle insertion. Complications from solution absorption include toxicity from overdose, idiosyncrasy from abnormal reactions, allergy, and anaphylaxis. Toxicity symptoms involve early CNS stimulation and late CNS depression that can lead to respiratory depression and death if not treated. Prevention focuses on careful patient evaluation, using minimum effective doses, and monitoring after injection. Needle insertion complications involve issues like fainting, infection, and nerve injury.
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This document outlines local and systemic complications that can occur from dental injections. It discusses various local complications including paresthesia, needle breakage, hematoma, pain on injection, facial nerve paralysis, infection, trismus, soft tissue injury, and edema. It also discusses rare ocular complications that can occur from inadvertent injection into blood vessels supplying the eye. Prevention and management strategies are provided for each complication. Systemic complications from overdose or allergy are also briefly covered. Predisposing factors that can increase risks of complications are outlined.
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Local anesthesia produces loss of sensation in a specific area without loss of consciousness. It is commonly used in dentistry for procedures like tooth extractions, fillings, and surgery to relieve pain. Local anesthetics work by depressing nerve conduction, preventing the generation and conduction of nerve impulses. They are contraindicated in patients with certain medical conditions like infections, liver or kidney disease, or cardiac issues.
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This document summarizes recent advances in local anesthesia for dentistry. It discusses newer local anesthetic drugs like articaine and centbucridine that are equally or more effective than lignocaine. It also describes new delivery systems for local anesthesia like computer-controlled local anesthesia delivery systems, jet injectors, and iontophoresis that reduce injection pain and improve patient comfort. Devices like CCLADs allow controlled infusion of anesthetic for more precise needle insertion and placement.
PHARMACOLOGY OF LOCAL ANESTHESIA
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
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Vasoconstrictors
This document summarizes vasoconstrictors which are drugs that constrict blood vessels and control tissue perfusion. It is added to local anesthetics (LA) to oppose their vasodilatory effects. Vasoconstrictors are classified as catecholamines like epinephrine and norepinephrine or noncatecholamines. They can act directly, indirectly, or mixed on receptors like alpha, beta 1,2,3 receptors. The maximum recommended doses for epinephrine are provided for healthy and cardiac patients. Dilutions of vasoconstrictors from 1:1000 to 1:200,000 are explained. The document also compares epinephrine and norepinephrine.
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This document discusses local anesthesia and pain control techniques for pediatric dentistry. It defines pain and anesthesia and covers various local anesthesia techniques including topical anesthesia, infiltration, nerve blocks, and supplemental injection techniques. It provides details on the contents of local anesthesia carpules, how local anesthetics are metabolized in the body, recommended dosages, and complications. The goal is to effectively manage pain for dental procedures in children.
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This document discusses various agents used for sedation. It begins by defining sedation and sedative drugs. There are two main types of sedation: conscious and unconscious. The document then discusses different classes of sedative drugs including gases like nitrous oxide and desflurane, antihistamines like hydroxyzine and diphenhydramine, hypnotic drugs like barbiturates, benzodiazepines, and chloral hydrate, and narcotics like fentanyl and meperidine. It provides details on the mechanism of action, dosages, side effects, and drug combinations for conscious sedation for many of the discussed sedative agents.
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This document provides information on general anesthesia, local anesthesia, and conscious sedation including:
- The key differences between general anesthesia, local anesthesia, and conscious sedation.
- The American Society of Anesthesiologists patient physical status classification system.
- The stages of general anesthesia according to Guedel and Gillespie.
- Common routes of administration for anesthesia including intravenous, inhalation, intramuscular, and oral.
- Common drugs used for intravenous and inhalation anesthesia like propofol, sevoflurane, and ketamine.
- Guidelines for preoperative, intraoperative, and postoperative care when providing general anesthesia.
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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.
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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.
NSAIDs IN DENTISTRY
The document summarizes non-steroidal anti-inflammatory drugs (NSAIDs). It discusses their mechanism of action by inhibiting cyclooxygenase enzymes and reducing prostaglandin formation, leading to analgesic, anti-inflammatory, and antipyretic effects. NSAIDs are classified based on selectivity for COX-1 and COX-2. Common NSAIDs and their uses for pain relief are described. Adverse effects include gastric irritation and bleeding. Dental considerations advise avoiding NSAIDs if allergic and not using aspirin before and after surgery due to bleeding risk.
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Local anesthetics produce localized, reversible nerve block by inhibiting sodium channels. They are commonly used for surface anesthesia, infiltration, nerve blocks, intravenous regional anesthesia, epidural anesthesia, and spinal anesthesia. Common local anesthetics include lidocaine, bupivacaine, procaine, and tetracaine which vary in duration of action from short to long. Adverse effects include allergic reactions and systemic toxicity.
local anesthetic
The document discusses local anesthetics, including their definition, history, ideal criteria, classification based on duration of action and chemical structure, examples used, pharmacokinetics, indications, adverse effects, contraindications, drug interactions, and routes of administration such as topical, nerve block, infiltration, spinal, and epidural. It also covers their mechanism of action in blocking voltage-gated sodium channels, factors affecting their reaction like lipid solubility and pH, and use of vasoconstrictors to prolong duration.
Local anesthetics
Local anesthetics work by reversibly blocking nerve conduction. They alter the nerve membrane potential and decrease nerve firing and depolarization rates. Local anesthetics are classified as esters, amides, or ketones. After injection, esters are quickly broken down while amides have longer half-lives and their toxicity is more likely if liver function is impaired. The onset and duration of local anesthetics are affected by tissue pH, concentration, and lipid solubility, with pH being most important. Adding epinephrine decreases systemic toxicity and increases duration by reducing absorption. Local anesthetic toxicity can cause CNS stimulation or depression as well as cardiovascular effects.
Orthopaedic analgesia and blocks
This document discusses orthopaedic analgesia and regional nerve blocks. It covers the classes of drugs used for pain management including local anesthetics, vasoconstrictors, opioids, sedatives, and others. It provides details on commonly used local anesthetics like lidocaine and bupivacaine, as well as vasoconstrictors, opioids, sedatives and other adjunct medications. The document also describes various regional nerve blocks that can be performed including digital, wrist, elbow, ankle, popliteal and Bier blocks. It concludes with a section on moderate sedation and appropriate monitoring.
Pharmacology of anesthesia
The PowerPoint is an overview of the pharmacology of anesthesia that can offer great assistance to beginner medical and nursing students who are oftentimes confused about these drugs
lecture 12 - General & Local Anaesthesia.pptx
General anesthesia involves controlled reversible depression of the central nervous system characterized by loss of consciousness, sensation, and muscle relaxation while maintaining hemodynamic stability. It works by inhibiting synaptic transmission in the CNS via GABA receptors or NMDA receptors. Common general anesthetics include inhalation agents like nitrous oxide, halothane, isoflurane and intravenous agents like thiopental and propofol. Local anesthetics cause reversible loss of sensation in a localized region without loss of consciousness by blocking nerve conduction. Common local anesthetics include lidocaine, bupivacaine and tetracaine. Both general and local anesthetics have the potential for adverse effects and toxicity if overdosed or accidentally injected intravascularly.
Reginal Block Anesthesia-anesthesia topic
Regional anesthesia techniques include topical anesthesia, local infiltration, field block, and nerve blockade. Common nerve blockades are brachial plexus and sciatic nerve blocks, as well as epidural and spinal analgesia. The greatest risk is local anesthetic toxicity from accidental intravascular injection or excessive dosing. Symptoms involve the central nervous system and treatments focus on supportive care, sedation, and ventilation support if needed. Proper technique and cautious dosing can help prevent local anesthetic toxicity risks.
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Systemic effects of LOCAL ANESTHESIA
- 1. SYSTEMIC EFFECTS OF LOCAL ANAESTHETICS DR. SWATI SAHU MDS FELLOW ORAL & MAXILLOFACIAL SURGERY
- 2. CNS • In one word : DEPRESSION • At high levels, LA will produce tonic-clonic convulsions • Procaine, Lidocaine etc produce ANTICONVULSANT properties.
- 3. • This drugs are used for management of grand mal & petit mal seizures • The depressant action of LA raise the seizure threshold by decreasing the excitability of cortical neurons in epileptic patients
- 4. PRECONVULSIVE SIGNS & SYMPTOMS • Numbness of the tongue & circumoral regions • If excitation or sedation occurs in the first 5 or 10 minutes after administration of LA, it should consider as a warning that convulsive activity could be possible. • Shivering, slurred speech, muscular twitching, visual/auditory disturbances, dizziness, drowsiness, disorientation & tremor.
- 5. CONVULSIVE PHASE • Duration of seizures is related to blood level of LA & inversely related to arterial pCO2 levels. • Seizures last less than or equal to one minute. • In seizure, 1) cerebral blood flow & 2) cerebral metabolism increase
- 6. 1 ) CEREBRAL BLOOD FLOW
- 7. 2 ) CEREBRAL METABOLISM
- 8. RESPIRATORY SYSTEM • DUAL EFFECTS : 1. Non-overdose levels : Direct relaxant action on bronchial smooth muscle 2. Overdose levels :
- 9. CVS • Direct action on myocardium & peripheral vasculature. • Increased LA blood levels result in decreased myocardial depolarization • Decrease in myocardial excitation, decrease in conduction rate & decrease in the force of contraction • Produces hypotension ( direct relaxation effect on vascular smooth muscle )
- 10. LOCAL TISSUE TOXICITY • Skeletal muscle will heal within 2 weeks of being injected with local anaesthetic. • Longer acting LA produces more damage to skeletal muscle than shorter acting LA.
- 11. TOXICITY OF LOCAL ANAESTHESIA 1- Causes 2- Factors reducing toxicity.
- 12. CAUSES • Accidental rapid intravenous injection. • Rapid absorption, such as from a very vascular site i.e mucous membranes. • Overdose
- 13. FACTORS REDUCING TOXICITY • Decide on the concentration of the local anaesthetic that is required for the block to be performed. Calculation of the total volume of drug should be done. • Use the least toxic drug available. • Use lower doses in frail patients or at the extremes of ages. • Always inject the drug slowly (around 1ml /minute) and aspirate regularly looking for blood to indicate an accidental intravenous injection
- 14. • If Injection of a test dose of 2-3ml of local anaesthetic containing adrenaline is accidentally given intravenously it will often (but not always) cause significant tachycardia. • Add adrenaline (epinephrine) to reduce the speed of absorption. The addition of adrenaline will reduce the maximum blood concentration by about 50%. Usually adrenaline is added in a concentration of 1:200,000, with a maximum dose of 200 micrograms. • Make sure that the patient is monitored closely by the anaesthetist or a trained nurse during the administration of the local anaesthetic and following the surgery.
- 15. ADVANTAGES OF LOCAL ANAESTHESIA • During local anesthesia the patient remains conscious • Maintains his own airway. • Excellent muscle relaxant effect. • Requires less skilled nursing care as compared to other anesthesia like general anesthesia. • Non inflammable.
- 16. • Less pulmonary complications • Aspiration of gastric contents unlikely. • Less nausea and vomiting. • Contracted bowel so helpful in abdominal and pelvic surgery. • Postoperative analgesia. • There is reduction surgical stress. • Earlier discharge for outpatients.
- 17. • Suitable for patients who recently ingested food or fluids. • Local anesthesia is useful for ambulatory patients having minor procedures. • Ideal for procedures in which it is desirable to have the patient awake and cooperative. • Less bleeding. • Expenses are less.
- 18. DISADVANTAGES OF LOCAL ANAESTHESIA • There are individual variations in response to local anesthetic drugs. • Rapid absorption of the drug into the bloodstream can cause severe, potentially fatal reactions. • Apprehension may be increased by the patient's ability to see and hear. • Some patients prefer to be unconscious and unaware.
- 19. • Direct damage of nerve. • Post-dural headache from CSF leak. • Hypotension and bradycardia through blockade of the sympathetic nervous system. • Not suitable for extremes of ages. • Multiple needle pricks may be needed.