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Results for “ANESTHETICS, LOCAL”

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At least 91 records · Page 5Linked to original sources
PubMed1986

Considerations in differential diagnosis of adverse reactions to local anesthetic: report of case.

A 62-year-old woman with reported allergies to procaine and lidocaine requested dental care. Consultation with the patient, the patient's physicians, and the patient's dentists did not identify the causes of the adverse reactions had occurred only when anesthetic was administered without vasoconstrictor. There were no reactions when vasoconstrictor was used. Skin testing by an allergist disclosed no evidence of true allergic reaction to any of the 'caine drugs. In addition, no evidence of reaction to preservatives was found during patch testing. The adverse reactions were determined to be caused by an idiosyncratic low threshold to toxic side effects of 'caine drugs. The use of vasoconstrictor (epinephrine) apparently promoted the retention of the anesthetic locally and prevented systemic absorption sufficient to cause the toxic reaction. Practitioners must be aware that adverse reactions to dental anesthetic may be a result of true allergy, psychogenic reaction (syncope), normal toxic overdose, or idiosyncratic toxic overdose.

Anesthesia, Dental↗
PubMed1976

Cell shape changes and transmembrane receptor uncoupling induced by tertiary amine local anesthetic.

Tertiary amine local anesthetics (dibucaine, tetracaine, procaine, etc.) modify cell morphology, concanavalin A (Con A)-mediated agglutinability and redistribution of Con A receptors. Con A agglutination of untransformed mouse 3T3 cells was enhanced at low concentrations of local anesthetics, and the dynamics of fluorescent-Con A indicated that ligand-induced clustering was increased in the presence of the drugs. In contast, these drugs inhibited Con A-induced receptor capping on mouse spleen cells. These effects can be duplicated by combinations of vinblastine (or colchicine) and cytochalasin B suggesting that local anesthetics act on microtubule and microfilament assemblies which are involved in the trans-membrane control of cell surface receptor mobility and distribution. It is proposed that tertiary amine local anesthetics displace plasma membrane-bound Ca2+, resulting in disengagement of microfilament systems from the plasma membrane and increased cellular Ca2+ concentration to levels which disrupt microtubular organization. The possible involvement of cellular Ca2+ in cytoskeletal destruction by local anesthetics was investigated utilizing Ca2+-specific ionophores A23187 and X537A. In media containing Ca2+ and cytochalasin B these ionophores caused effects similar to tertiary amine local anesthetics.

Agglutination↗
PubMed2004

Local anesthetics reduce mortality and protect against renal and hepatic dysfunction in murine septic peritonitis.

BACKGROUND: Mortality from sepsis frequently results from multiple organ injury and dysfunction. Cecal ligation and puncture is an established murine model of septic peritonitis that produces septic shock characterized by an initial hyperinflammatory response. In addition to their anesthetic properties, local anesthetics have been shown to attenuate inflammatory responses both in vivo and in vitro. In the current study, the ability of local anesthetic infusions to protect against sepsis-induced mortality, as well as renal and hepatic dysfunction after cecal ligation and puncture, was investigated. METHODS: C57BL/6 mice received mini-osmotic pumps containing saline (vehicle), 10% lidocaine, or 1% bupivacaine and were subjected to cecal ligation and puncture. Twenty-four hours after cecal ligation and puncture, renal and hepatic functions were assessed as well as markers of inflammation (proinflammatory cytokine protein and mRNA concentrations and myeloperoxidase activity). Renal apoptosis and 7-day survival was also assessed. RESULTS: Mice treated with lidocaine or bupivacaine infusion showed improved survival and had significantly lower plasma creatinine, aspartate aminotransferase, and alanine aminotransferase concentrations compared with mice receiving vehicle alone. Significant reduction in plasma tumor necrosis factor-alpha and keratinocyte-derived chemokine, as well as reductions in myeloperoxidase activity, intracellular adhesion molecule-1 protein expression, mRNA concentrations of proinflammatory markers, and apoptosis were observed in renal cortices from both local anesthetic groups. CONCLUSIONS: The current data demonstrate that local anesthetic infusions confer a protective effect in mice from septic peritonitis by attenuating the hyperacute inflammatory response. This suppression resulted in improved mortality and less progression to acute kidney and liver injury and dysfunction.

Anesthetics, Local↗
PubMed2006

Low-dose combined spinal-epidural anesthesia for cesarean delivery: a comparison of three plain local anesthetics.

The new local anesthetics have been poorly studied for intrathecal use during Cesarean section surely in low doses and in combination with an opioid substance. The purpose of the present study was to compare bupivacaine and the newer local anesthetics in equipotent doses. During the induction of combined spinal-epidural anesthesia, 91 elective Cesarean section patients were randomly assigned to receive a spinal injection of either 10 mg ropivacaine or 6.6 mg bupivacaine or levobupivacaine both combined with sufentanil 3.3 microg. After securing the epidural catheter patients were turned to the supine position respecting a 15 degrees left lateral tilt. The three local anesthetics were compared with respect to sensory and motor block, the need for epidural supplementation, the severity of hypotension and neonatal outcome. More patients in bupivacaine had a Bromage-3 motor block at incision. The ropivacaine group required additional local anesthetics by the epidural route in 23% of the cases versus 10% in the bupivacaine group and 9% with levobupivacaine. This caused the interval between the spinal injection and the end of surgery to be longer in the ropivacaine group. Hemodynamic values were comparable between the three groups although a trend towards better systolic blood pressures and a lower incidence of severe hypotension were noticed in favor of levobupivacaine. Apgar scores and umbilical pH values did not differ. When performing a low-dose combined spinal-epidural technique for Cesarean section, the present study confirms that the new local anesthetics can be used successfully, induce less motor block but that ropivacaine requires at least a 50% larger dose than bupivacaine or levobupivacaine.

Adjuvants, Anesthesia↗
PubMed2003

Local anesthetics in dentistry: then and now.

Local anesthetics have been in use in dental practice for more than 100 years. The advent of local anesthetics with the development of nerve blockade injection techniques heralded a new era of patient comfort while permitting more-extensive and invasive dental procedures. A brief history and summary of the current local anesthetics available in the United States is provided, and some of the newest techniques for delivering local anesthetics are reviewed. General guidelines for addressing difficulties encountered in anesthetizing patients are also discussed.

Anesthesia, Dental↗