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Pharmacology of Local Anesthetics
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
The adverse effects that may follow administration of a local anesthetic agent can be a result of the physiological consequences of blocking the function of certain nerves, local tissue toxicity, or systemic toxicity. Physiological effects are most commonly due to blockade of the sympathetic nervous system and are most relevant following epidural and spinal anesthesia or analgesia (see Chapter 9).
Intralesional nail therapies
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Chander Grover, Geetali Kharghoria
Intralesional injections for nail diseases are easily and efficiently done as an outpatient office procedure. The post-injection period is expected to be uneventful, and the patient can resume normal activities soon. If digital anesthesia has not been administered (which we normally do not use!), there is no expected downtime, even though a minority of patients can perceive tingling or some numbness till the day end. If digital block has been used, the duration of anesthesia will depend on the anesthetic agent used.
Heterocyclic Drug Design and Development
Published in Rohit Dutt, Anil K. Sharma, Raj K. Keservani, Vandana Garg, Promising Drug Molecules of Natural Origin, 2020
Garima Verma, Mohammad Shaquiquzzaman, Mohammad Mumtaz Alam
Local anesthetic agents are the ones which are used clinically for producing reversible loss of sensation in a circumscribed area of the body. These agents are used in case of acute pain, chronic pain, and surgery. They bring about the reversible interruption of impulse conduction. A few local anesthetic agents naturally obtained from plants are discussed in Table 9.13.
Updates on Enhanced Recovery after Surgery protocols for plastic surgery of the breast and future directions
Published in Baylor University Medical Center Proceedings, 2023
Nicholas F. Lombana, Ishan M. Mehta, Caiwei Zheng, Reuben A. Falola, Andrew M. Altman, Michel H. Saint-Cyr
The pharmacokinetics of such drugs is further influenced by the acid dissociation constant, pKa, lipid solubility, and protein binding of each agent.14 Agents with a pKa closer to body acidity, pH 7.4, have a faster onset of action, secondary to ease of passage across the nerve cell membrane.14 The choice of local anesthetic agent is dependent on several factors including patient allergies, desired duration of action, and desired onset. For example, lidocaine has been shown to provide anesthesia for 1 to 3 hours and bupivacaine for up to 10 hours.14,15 It is particularly important to be cognizant of local anesthetic agent dosing to prevent local anesthetic toxicity. The reported maximum dose for lidocaine with epinephrine is 7 mg/kg; for lidocaine without epinephrine, 4.5 mg/kg; and for bupivacaine (with or without epinephrine), 2 to 3 mg/kg.14,15
Lidocaine-loaded dissolving microneedle for safe local anesthesia on oral mucosa for dental procedure
Published in Expert Opinion on Drug Delivery, 2023
Hyunkyu Lee, Hye Su Min, Mingyu Jang, Geonwoo Kang, Seongdae Gong, Chisong Lee, Young Woo Song, Ui-Won Jung, Somin Lee, Hyeon Yeol Ryu, Huisuk Yang, Hyungil Jung
In general, the effect of a long-acting local anesthetic agent lasts for a few hours, and the active compounds are usually delivered through injection to alleviate pain during the dental procedure [3]. However, the pain caused by needle insertion brings a great sense of fear to the patient and may cause the patient to feel reluctant to undergo dental treatment [4]. Therefore, topical application of primary anesthesia via short-acting local anesthetics has been used to control the initial pain caused by injection [5]. Among various short-acting local anesthetic agents, lidocaine has been widely used to reduce the pain caused by needle insertion [6]. Lidocaine has been developed in various formulations such as gels, ointments, sprays, and solutions [7]. Of these, the gel-type lidocaine is widely used, as it is well absorbed without leaking from the oral mucosa owing to its high viscosity compared to other formulations [8]. Although these gel-type agents have been commonly used, the fact that only few lidocaine molecules reach the nerve cells due to the oral mucosal barrier could be considered as a limitation. Therefore, in dental treatment, a novel drug delivery system for local anesthetic agents is required to overcome the oral mucosal barrier.
Review of the international hypnosis literature
Published in American Journal of Clinical Hypnosis, 2022
Shelagh Freedman, Ian Wickramasekera
The authors present the results of a prospective study conducted in Spain on the effects of hypnosis versus distraction to help children undergoing dermatological procedures with their pain and distress. A total of 65 child patients were included in the study with 33 patients receiving hypnosis administered during the procedure by a member of the medical team. The children in the hypnosis condition were found to require less anesthetic agent and other pain related medications, such as propofol and ibuprofen, both during the procedure and a day later. They also gave lower ratings of their pain and higher ratings of their satisfaction with the dermatological procedure than the children in the distraction group. The authors concluded that hypnosis was an effective way of not only reducing the anesthetic and analgesic medications required, but also for increasing the wellbeing and satisfaction of both the children undergoing the procedures and their caregivers. Address for reprints: Dr. Peláez Pérez Juana Maria, Department of Anesthesia, Division of Pediatria, Puerta del Mar University Hospital of Cádiz, University of Cádiz, 11009 Cádiz, Spain. E-Mail address: [email protected].