Local Anesthetisia

Local Anesthetic Agent

(Component) Block nerve conduction.

Sodium Chloride

(Component) Isotonicity of solution

Sterile Water

(Component) Volume.

Vasoconstrictor

(Component) Increase depth and duration.

Vasoconstrictor

(Component) Decrease absorption and hemostasis.

Sodium Bisulfate

(Component) Antioxidant.

Methylparabens

(Component) Bacteriostatic.

Ultra-short acting L.A

2% lidocaine without vasoconstrictor.

Short acting L.A

2% lidocaine with 1:100,000 epinephrine.

Short acting L.A

Mepivacaine without vasoconstrictor.

Medium acting L.A.

2 % Mepivacaine with 1:20,000 levonordefrin.

Long acting L.A.

0.5% Bupivacaine with 1:200,000 epinephrine.

Liver

Amides are metabolized in?

Amides

(Classification) Faster onset.

Amides

(Classification) Less risk of allergic reactions.

Blood Plasma

Esters are metabolized in?

(Classification) Not generally used (more toxic).

Para-Aminobenzoic acid (PABA)

Esters have allergic reaction risk due to?

Cardiac CNS

LA toxicity progress to _______ ___ signs.

Arrhythmias - Asystole

Severe toxicity lead to (2)?

Esters

These local anaesthetics are known sensitisers and therefore are associated with allergic reactions.

Cross-reactivity

________________ between ester local anaesthetics is also common.

Yes

Are LA allergies rare?

Patch Testing - Skin Testing

Testing of LA allergies (2).

Epinephrine/Adrenaline - Levonordefrin

Prolongs numbness, reduces toxicity, promotes hemostasis (2).

Phenylephrine

For patients that cannot or needs to limit the use of use epinephrine.