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Chapter 26

Chapter 26. Local Anesthetics. Local Anesthetics. Suppress pain by blocking sodium channels, thereby blocking impulse conduction along axons Only in neurons located near the site of administration Suppress pain without generalized depression of nervous system. Local Anesthetics.

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Chapter 26

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  1. Chapter 26 Local Anesthetics

  2. Local Anesthetics • Suppress pain by blocking sodium channels, thereby blocking impulse conduction along axons • Only in neurons located near the site of administration • Suppress pain without generalized depression of nervous system

  3. Local Anesthetics • Basic pharmacology of local anesthetics • Properties of individual local anesthetics • Clinical use of anesthetics

  4. Basic Pharmacology of Local Anesthetics • Classification • Esters • Amides

  5. Fig.26–1. Structural formulas of representative local anesthetics.

  6. Basic Pharmacology of Local Anesthetics • Mechanism of action • Suppress pain by blocking sodium channels, thereby blocking impulse conduction along axons

  7. Basic Pharmacology of Local Anesthetics • Selectivity of anesthetic effects • Only in neurons located near the site of administration • Suppress pain without generalized depression of nervous system

  8. Time Course of Local Anesthesia • Onset of local anesthesia • Termination of local anesthesia • Impact of regional blood flow

  9. Basic Pharmacology of Local Anesthetics • Use with vasoconstrictors • Prolong anesthesia • Reduce the risk for toxicity—slow absorption • Fate in the body • Absorption • Distribution • Metabolism

  10. Basic Pharmacology of Local Anesthetics • Adverse effects • CNS • Cardiovascular • Allergic reaction • Labor and delivery

  11. Properties of Individual Local Anesthetics • Procaine • Lidocaine • Cocaine • Other local anesthetics

  12. Procaine • Was formerly the anesthetic of choice for injection • Now replaced by others • Preparations • Available in solution (1%, 2%, and 10%)

  13. Lidocaine • Most widely used local anesthetic • Topical and injectable applications • Effects extended if given with epinephrine • Also used for cardiac dysrhythmias

  14. Lidocaine • Preparations • Cream • Ointment • Jelly • Solution • Aerosol • Patch

  15. Cocaine • First local anesthetic • Central nervous system (CNS) effects • Peripheral nervous system (PNS) effects (sympathetic) • Cardiovascular effects • Preparation and administration • Should not be given with vasoconstrictor

  16. Other Local Anesthetics • Grouped according to route • Topical • Injection

  17. Other Local Anesthetics • Topical • Therapeutic uses • Systemic toxicity • Injection • Infiltration, nerve block, IV regional, epidural, and spinal (subarachnoid) • Should be administered by anesthesiologist • IV and monitoring required

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