Clinical Use Of Local Anesthetics

Local anesthetics are being increasingly applied in different surgeries. Lower side effects of neuroaxial anesthesia, regional anesthesia, and field block, in comparison to general anesthesia (volatile and intravenous agents), are the main reasons why physicians prefer to conduct surgeries under local anesthesia, especially in outpatient and day care surgeries. It is important to emphasize the presence of an anesthesiologist, and vigilant monitoring of the homodynamic parameters, in decreasing a patient's anxiety, exerting other modalities for analgesia and increasing the safety margin in many procedures.

This concise, evidence-based board review book, organized according to the ABA keyword list, covers all the fundamental concepts needed to pass written and re-certification board examinations. Each chapter begins with a case scenario or clinical problem from everyday practice, followed by concise discussion and clinical review questions and answers. Discussion progresses logically from preoperative assessment and intraoperative management to postoperative pain management, enhancing the reader's knowledge and honing diagnostic and clinical management skills. New guidelines and recently developed standards of care are also covered. Serving as a companion to the popular textbook Essential Clinical Anesthesia, this resourceful work reflects the clinical experiences of anesthesia experts at Harvard Medical School as well as individually known national experts in the field of anesthesiology. This practical review is an invaluable resource for anesthesiologists in training and practice, whether studying for board exams or as part of continuing education and ABA recertification.

Local anesthetics are among the most widely used drugs. Their development over the past century ranges from a documented influence on Freud's Interpretation of Dreams 1 to the synthesis of the ubiquitously popular lidocaine, as described in Chapter 1. For surgical procedures the use of regional, epidural and intrathecal local anesthesia has increased continuously during the past decade. Local anesthetics are also applied by physicians to ameliorate unpleasant sensations and reactions to other procedures, such as tracheal intubation. The presence or the threat of cardiac arrhythmias is often countered by chronic administration oflocal anesthetic-like agents, such as lidocaine or procainamide. Relief of acute pain, accompanying dental manipulations, for example, and of chronic pain are also accomplished with traditional local anesthetics. And over-the-counter formula tions of topical local anesthetics provide practitioners of solar indiscretion welcome relief from their otherwise unaccommodating sunburn. In all these applications the final effect of the local anesthetic is an inhibition of electrical activity, accomplished as a reduction or total blockade of action potentials. The primary site of action is the sodium channel, a transmembrane protein which is essential for the influx of sodium ions that subserves impulse generation and propagation in nerves, skeletal muscle, and heart. The detailed mechanisms oflocal anesthetic action are still being investigated and Chapter 2 of this volume provides a current overview of that subject.

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.

The Essence of Analgesia and Analgesics is an invaluable practical resource for clinicians giving pain relief in any clinical setting, describing the pharmacologic principles and clinical use of all available pain medications. As well as detailed overviews of pain processing and analgesic theory, sections are dedicated to oral and panteral opioid analgesics, neuraxial opioids, NSAIDs, local anesthetics, anticonvulsant type analgesics, NMDA antagonists, alpha adrenergic analgesics, antidepressant analgesics, muscle relaxants, adjuvant medications, and new and emerging analgesics. The concise format of the chapters allows for quick and easy reading and assimilation of information. Enhanced by summary tables and figures, each chapter provides an overview of a particular drug, covering chemical structure, mode of activity, indications, contraindications, common doses and uses, advantages and disadvantages, and drug related adverse events. Key references are also provided. Edited by leading experts in pain management, this is essential reading for any clinician involved in pain management.

Local Anaesthesia in Dentistry is a practical guide for both students and general practitioners to this essential area of clinical practice. Highly illustrated in full colour throughout, the book provides clear and practical guidance to the administration of local anaesthesia. The book introduces the reader to the concept of nerve conduction and pain as well as providing an explanation of the anatomy of the trigeminal nerve. Further chapters cover such key areas of practice as regional anaesthesia, local anaesthesia in children, pharmacology, local and systemic complications, general practical aspects, the prevention of side effects and legal aspects.

A concise, clinically-oriented manual designed to provide information on the pharmacologic actions and interactions of locally administered drugs. The author, an associate professor of anesthesiology at Ohio State University, organizes the volume's 38 chapters into five sections: physiology, the basic properties of specific esters, the basic properties of specific amides, additives and compounds, and surgical applications of local anesthetics. Annotation copyrighted by Book News, Inc., Portland, OR

Synthesis of Essential Drugs describes methods of synthesis, activity and implementation of diversity of all drug types and classes. With over 2300 references, mainly patent, for the methods of synthesis for over 700 drugs, along with the most widespread synonyms for these drugs, this book fills the gap that exists in the literature of drug synthesis. It provides the kind of information that will be of interest to those who work, or plan to begin work, in the areas of biologically active compounds and the synthesis of medicinal drugs. This book presents the synthesis of various groups of drugs in an order similar to that traditionally presented in a pharmacology curriculum. This was done with a very specific goal in mind – to harmonize the chemical aspects with the pharmacology curriculum in a manner useful to chemists. Practically every chapter begins with an accepted brief definition and description of a particular group of drugs, proposes their classification, and briefly explains the present model of their action. This is followed by a detailed discussion of methods for their synthesis. Of the thousands of drugs existing on the pharmaceutical market, the book mainly covers generic drugs that are included in the WHO’s Essential List of Drugs. For practically all of the 700+ drugs described in the book, references (around 2350) to the methods of their synthesis are given along with the most widespread synonyms. Synthesis of Essential Drugs is an excellent handbook for chemists, biochemists, medicinal chemists, pharmacists, pharmacologists, scientists, professionals, students, university libraries, researchers, medical doctors and students, and professionals working in medicinal chemistry. * Provides a brief description of methods of synthesis, activity and implementation of all drug types* Includes synonyms* Includes over 2300 references

This Second Edition is a significant revision of the leading text and clinical reference on pediatric pain. Written by an international group of experts from all relevant disciplines, this new edition is a vital reference for all pain practitioners, and for nurses, psychologists, PTs, anesthesiologists, and pediatricians dealing with acute and chronic pediatric pain. This edition includes new and expanded information on NSAIDs, opioids, and regional anesthesia. New chapters cover sedation, pain in the ICU, multidisciplinary pain services, palliative care, and the long-term consequences of pain. User-friendly new features include many more illustrations of techniques.

Rev. ed. of: Peripheral nerve blocks: principles and practice. c2004.