scholarly journals The toxic impact of local anaesthetics in menopausal women: causes, prevention and treatment after local anaesthetic overdose. Local anaesthetic systemic toxicity syndrome

2015 ◽  
Vol 1 ◽  
pp. 65-70
Author(s):  
Bogusław Sobolewski ◽  
Paweł Doman ◽  
Tomasz Stetkiewicz ◽  
Przemysław Oszukowski ◽  
Piotr Woźniak
Keyword(s):  
Local Anaesthetic ◽  
Local Anaesthetics ◽  
Systemic Toxicity ◽  
Toxic Impact ◽  
Menopausal Women ◽  
Prevention And Treatment

scholarly journals Private Practitioners Knowledge of Local Anaesthetic Systemic Toxicity (LAST)

2021 ◽  
Vol 10 (41) ◽  
pp. 3571-3576
Author(s):  
Neha Yadav ◽  
Reshu Madan Sanan ◽  
Shefali Phogat ◽  
Nisha Yadav ◽  
Nupur Dabas ◽  
...  
Keyword(s):  
Local Anaesthetic ◽  
Anaesthetic Agent ◽  
Nerve Impulse ◽  
Local Anaesthetics ◽  
Systemic Toxicity ◽  
Blood Levels ◽  
Private Practitioners ◽  
Adequate Knowledge ◽  
Online Mode ◽  
Administration Methods

BACKGROUND Local anaesthetics (LAs) by definition are drugs that reversibly block the transmission of a nerve impulse, causing reversible absence of pain sensations without affecting consciousness. As a complication of local anaesthetic administration, a condition called as local anaesthetic systemic toxicity (LAST) can occur which affects central nervous system (CNS) and cardiovascular system (CVS). Local anaesthetic systemic toxicity is a very serious condition that can cause death. In LAST, blood levels of anaesthetic agent exceed the maximum dose, usually as a result of multiple injections or an accidental injection into a vein. The main objective of this survey was to assess the knowledge of LAST among private practitioners and to spread awareness about this common but often neglected complication of local anaesthetic administration. METHODS A survey was conducted with a questionnaire comprising of 15 questions for 251 private practitioners (registered in Indian Dental Association, Gurugram). The survey was mailed to the participants and the response was collected through online mode only. Using Excel program, the results were organized in graphs and tables, and presented as descriptive statistics. RESULTS Of the 251 surveys sent online, 151 were completed, with a survey completion rate of 60 %. On an average, only 39.9 % of the participating dentists had adequate knowledge of local anaesthetic systemic toxicity. Based on the survey, only 3.3 % of participating dentists knew how to use lipid treatment and 55.6 % had no idea about lipid treatment. CONCLUSIONS If LAST occurs, the key is to recognize it immediately and institute appropriate management. Based on the survey, there is a need to create awareness about local anaesthetic systemic toxicity and its management among dentists. KEY WORDS Local Anaesthesia, Last, Complication, Toxicity, Overdose

Local anaesthetic agents

2017 ◽  
Author(s):  
Malachy O. Columb
Keyword(s):  
Local Anaesthetic ◽  
Neuronal Damage ◽  
Scientific Evidence ◽  
Local Anaesthetics ◽  
Systemic Toxicity ◽  
Lipid Solubility ◽  
Blood Concentrations ◽  
Anaesthetic Agents ◽  
Weak Bases ◽  
Initiation And Propagation

Local anaesthetic agents cause a pharmacologically induced reversible neuropathy characterized by axonal conduction blockade. They act by blocking the sodium ionophore and exhibit membrane stabilizing activity by inhibiting initiation and propagation of action potentials. They are weak bases consisting of three components: a lipophilic aromatic ring, a link, and a hydrophilic amine. The chemical link classifies them as esters or amides. Local anaesthetics diffuse through the axolemma as unionized free-base and block the ionophore in the quaternary ammonium ionized form. The speed of onset of block is therefore dependent on the pKa of the agent and the ambient tissue pH. Esters undergo hydrolysis by plasma esterases and amides are metabolized by hepatic microsomal mixed-function oxidases. Local anaesthetics are bound in the blood to α‎1-acid glycoproteins. Pharmacological potency is dependent on the lipid solubility of the drug as is the potential for systemic toxicity. The blood concentrations required to cause cardiovascular system (CVS) collapse and early central nervous system (CNS) toxicity are used to quantify the CVS:CNS toxicity ratio. Local anaesthetics also have the potential to induce direct neuronal damage. Intravenous lipid emulsion is used for the treatment of systemic toxicity but the scientific evidence is inconsistent. With regard to the pipecoloxylidine local anaesthetics, early evidence indicated that the S- was less toxic than the R-enantiomer. However, clinical research using minimum local analgesic concentration designs suggests that reduced systemic toxicity and motor block sparing is mainly explained by potency rather than enantiomerism.

Raloxifene for the prevention and treatment of osteoporosis in post-menopausal women

2000 ◽  
Author(s):  
A Cranney ◽  
V Robinson ◽  
G Guyatt ◽  
N Krolicki ◽  
JD Adachi ◽  
...  
Keyword(s):  
Treatment Of Osteoporosis ◽  
Menopausal Women ◽  
Prevention And Treatment ◽  
Post Menopausal

Updates in our understanding of local anaesthetic systemic toxicity: a narrative review

Anaesthesia ◽  
2021 ◽  
Vol 76 (S1) ◽  
pp. 27-39
Author(s):  
A. J. R. Macfarlane ◽  
M. Gitman ◽  
K. J. Bornstein ◽  
K. El‐Boghdadly ◽  
G. Weinberg
Keyword(s):  
Local Anaesthetic ◽  
Systemic Toxicity ◽  
Narrative Review

THE PROBLEM OF OSTEOPOROSIS IN MENOPAUSAL WOMEN AND POSSIBLE SOLUTIONS

2021 ◽  
Vol 2 (1) ◽  
pp. 15-17
Author(s):  
Maiorova M.O.
Keyword(s):  
Hormone Therapy ◽  
Bone Tissue ◽  
Calcium Metabolism ◽  
Management Strategy ◽  
Menopausal Hormone Therapy ◽  
Effective Management ◽  
Treatment Of Osteoporosis ◽  
Menopausal Women ◽  
Prevention And Treatment

41 women with osteoporosis were examined. The age of the examined people ranged from 50 to 60 years. All the women were postmenopausal. As a result of the study, it was found that the most effective management strategy for such patients is a combination of menopausal hormone therapy and non-hormonal drugs that affect calcium metabolism in bone tissue, improve its metabolism and reduce resorption. If there are contraindications to MGT, prevention and treatment of osteoporosis should also be carried out using the appointment of non-hormonal drugs. In this case, the use of ipriflavone is effective.

scholarly journals The effect of butacaine on adenine nucleotide binding and translocation in rat liver mitochondria

1975 ◽  
Vol 148 (3) ◽  
pp. 527-531 ◽  
Author(s):  
D R Fayle ◽  
G J Barritt ◽  
F L Bygrave
Keyword(s):  
Rat Liver ◽  
Local Anaesthetic ◽  
Binding Sites ◽  
Adenine Nucleotide ◽  
Adenine Nucleotides ◽  
Nucleotide Binding ◽  
Local Anaesthetics ◽  
Liver Mitochondria ◽  
Rat Liver Mitochondria ◽  
Mitochondrial Inner Membrane

The effect of the local anaesthetic, butacaine, on adenine nucleotide binding and translocation in rat liver mitochondria partially depleted of their adenine nucleotide content was investigated. The range of butacaine concentrations that inhibit adenine nucleotide translocation and the extent of the inhibition are similar to the values obtained for native mitochondria. Butacaine does not alter either the total number of atractyloside-sensitive binding sites of depleted mitochondria, or the affinity of these sites for ADP or ATP under conditions where a partial inhibition of the rate of adenine nucleotide translocation is observed. The data are consistent with an effect of butacaine on the process by which adenine nucleotides are transported across the mitochondrial inner membrane rather than on the binding of adenine nucleotides to sites on the adenine nucleotide carrier. The results are briefly discussed in relation to the use of local anaesthetics in investigations of the mechanism of adenine nucleotide translocation.

Local anaesthetics: Theoretical aspects

2021 ◽  
pp. 175573802110351
Author(s):  
Gareth Allen ◽  
Rebecca Butler
Keyword(s):  
Primary Care ◽  
Adverse Effects ◽  
Surgical Procedures ◽  
Local Anaesthetic ◽  
Secondary Care ◽  
Local Anaesthetics ◽  
Clinical Use ◽  
Minor Surgical Procedures ◽  
Nervous Conduction

Local anaesthetics are frequently used in both primary and secondary care. These agents transiently reduce the nervous conduction of nociceptive signals, reducing sensations of pain. In primary care, local anaesthetics are often used for minor surgical procedures. However, there are other uses for these agents. It is important to understand the issues encountered when using local anaesthetics in primary care. This review will cover clinical use, relevant pharmacology and adverse effects of the different local anaesthetic preparations.

Topical Anaesthesia to Reduce Pain Associated with Carpal Tunnel Surgery

2002 ◽  
Vol 27 (5) ◽  
pp. 462-464 ◽  
Author(s):  
T. M. LAWRENCE ◽  
V. V. DESAI
Keyword(s):  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Carpal Tunnel Release ◽  
Statistical Significance ◽  
Eutectic Mixture ◽  
Local Anaesthetics ◽  
Needle Insertion ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Carpal Tunnel Surgery

This randomized, double-blinded study assessed the effectiveness of a topical anaesthetic, eutectic mixture of local anaesthetics (EMLA), in reducing pain associated with carpal tunnel release performed under local anaesthetic. Fifty-six patients undergoing carpal tunnel release under local anaesthetic were randomized into either EMLA ( n=29) or placebo ( n=27) groups. Visual analogue pain scores were obtained for needle insertion, injection of anaesthetic and surgery itself. Pain scores were significantly less for needle insertion ( P=0.001) and injection of anaesthetic ( P=0.0005). Scores related to surgery were also lower in the EMLA group, but this did not reach statistical significance.

scholarly journals Effect of local anaesthetics on mitochondrial membrane potential in living cells

1990 ◽  
Vol 271 (1) ◽  
pp. 269-272 ◽  
Author(s):  
M Grouselle ◽  
O Tueux ◽  
P Dabadie ◽  
D Georgescaud ◽  
J P Mazat
Keyword(s):  
Cell Culture ◽  
Membrane Potential ◽  
Local Anaesthetic ◽  
Mitochondrial Membrane ◽  
Transmembrane Potential ◽  
Local Anaesthetics ◽  
Living Cells ◽  
Lipid Solubility ◽  
Laser Dye ◽  
Lipophilic Anion

Using the laser dye rhodamine 123, we demonstrated that local anaesthetics can reach mitochondria in cell culture and reversibly decrease, or even collapse, their transmembrane potential. This effect is highly dependent on the lipid-solubility of the local anaesthetic and can be facilitated by the presence of a lipophilic anion.

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