Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 83 views

    Local Anesthetics

    Uploaded by

    Luluul Maghfiroh
    Local anesthetics work by reversibly blocking sodium channels and preventing the propagation of action potentials. This produces a loss of sensation in the applied area without loss of consciousness. There are two main classes - esters and amides - which differ in how they are metabolized. Higher lipid solubility increases potency but also toxicity risk. Techniques include infiltration, nerve blocks, and regional blocks. Proper dosage and use of vasoconstrictors can prolong duration while minimizing risks of systemic side effects like seizures, low heart contractility, and low blood pressure.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Local Anesthetics

    Uploaded by

    Luluul Maghfiroh
    83 views35 pages
    Local anesthetics work by reversibly blocking sodium channels and preventing the propagation of action potentials. This produces a loss of sensation in the applied area without loss of consciousness. There are two main classes - esters and amides - which differ in how they are metabolized. Higher lipid solubility increases potency but also toxicity risk. Techniques include infiltration, nerve blocks, and regional blocks. Proper dosage and use of vasoconstrictors can prolong duration while minimizing risks of systemic side effects like seizures, low heart contractility, and low blood pressure.

    Original Title

    Local_anesthetics.ppt

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Local anesthetics work by reversibly blocking sodium channels and preventing the propagation of action potentials. This produces a loss of sensation in the applied area without loss of consciousness. There are two main classes - esters and amides - which differ in how they are metabolized. Higher lipid solubility increases potency but also toxicity risk. Techniques include infiltration, nerve blocks, and regional blocks. Proper dosage and use of vasoconstrictors can prolong duration while minimizing risks of systemic side effects like seizures, low heart contractility, and low blood pressure.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    83 views35 pages

    Local Anesthetics

    Uploaded by

    Luluul Maghfiroh
    Local anesthetics work by reversibly blocking sodium channels and preventing the propagation of action potentials. This produces a loss of sensation in the applied area without loss of consciousness. There are two main classes - esters and amides - which differ in how they are metabolized. Higher lipid solubility increases potency but also toxicity risk. Techniques include infiltration, nerve blocks, and regional blocks. Proper dosage and use of vasoconstrictors can prolong duration while minimizing risks of systemic side effects like seizures, low heart contractility, and low blood pressure.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    You are on page 1of 35

    Local anesthetics

    Kuliah Blok Traumatology 2018


    Objectives
    • Recall how an action potential is generated and
    propagated
    • Classify local anesthtics
    • Describe the machanism of action,
    pharmacokinetics and toxic effects of local
    anesthetics
    • Describe the different techniqes of use of LA
    • Describe the risks and benefits of using
    vasoconstrictors with LA
    Overview
    • Local anesthetics produce a transient
    and reversible loss of sensation
    (analgesia) in a circumscribed region
    of the body without loss of
    consciousness.

    • Normally, the process is completely


    reversible.
    ANESTHETICS
    • Local anesthetics - esters or
    amides
    –a lipophilic aromatic group
    –to a hydrophilic, ionizable
    amine.

    • Most are weak bases


    Classification of LA

    Esters

    • Benzocaine

    • Procaine/

    • Proparacaine
    Classification of LA
    Amide
    • Bupivacaine

    • Levobupivacaine

    • Lidocaine/Lignocaine

    • Mepivacaine
    Ionized
    • Local anesthetics gain access to the
    inner axonal membrane by

    1. traversing sodium channels while they


    are more often in an open
    configuration

    2. passage directly through the plasma


    membrane
    • Block
    inititation
    and
    propagatio
    n of action
    potential
    Sequence of clinical anesthesia

    •Sympathetic block (vasodilatation)


    •Loss of pain and temperature sensation
    •Loss of proprioception
    •Loss of touch and pressure sensation
    •Loss of motor function
    Anesthetic Potency

    • Potency = lipid solubility

    • Higher solubility = can use a


    lower concentration and reduce
    potential for toxicity
    DURATION OF ACTION

    • Duration = protein binding

    • Bupivacaine 95%
    Lidocaine 65%
    Pharmacokinetics
    • Effective within 5 min
    • Duration of action – 1-1.5 h
    • Activity is Ph dependent
    • Increased action in acidic ph
    CLEARANCE

    • ESTERS
    hydrolysis via cholinesterase

    • AMIDES
    metabolism via hepatic enzymes
    LA

    • Infiltration anesthesia

    • Regional anesthesia

    • Surface anesthesia
    LA

    • Infiltration anesthesia

    • Regional anesthesia

    • Surface anesthesia
    Regional anaesthesia

    • Nerve block

    • Intravenous

    • Extradural

    • Intrathecal block/ spinal anaesthesia


    Nerve block

    • Inject a drug around


    the nerve

    • Anaesthetise a region
    Intravenous

    • 0.5-1% lidocaine
    without adrenaline
    Extradural/epidural

    • Thoracic, lumbar,
    sacral
    • Act on nerve roots
    • No hypotention
    Spinal anesthesia

    • Sympathetic nerve
    block
    • hypotension
    LA

    • Infiltration anesthesia

    • Regional anesthesia

    • Surface anesthesia
    • On intact skin – eutectic
    mixture of bases of
    prilocaine (EMLA)

    • Slow absorption
    Prolongation of action

    • Add vasoconstrictor –
    adrenaline

    • Can use a larger dose

    • Not to – fingers, toes, nose,


    penis
    Adverse effects

    • LA’s cause some vasodilatation at


    site

    • LA toxicity related to rate of


    absorption via blood flow
    Systemic Toxicity

    • Blockage of voltaged-gated Na
    channel affects action potential
    propagation throughout the body

    • Potential is present for systemic


    toxicity
    Effects of local anesthetics

    • Excitation – anxiety, agitation,


    restlessness

    • Convulsions

    • Reduced myocardial contractility

    • Vasodilatation

    You might also like