Update on the pharmacology and effects of local anesthetics.

[Update on the pharmacology and effects of local anesthetics.] Anaesthesist. 2014 Apr 3; Authors: Ahrens J, Leffler A Abstract Local anesthetics (LA) are broadly used in all disciplines and it could be considered that relatively little is reflected on the mechanisms of action of this old substance group. However, several molecular mechanisms of LAs mediating wanted and unwanted effects remain to be explored. Furthermore, the number of indications for application of LAs seems to be expanding. The local anesthetic effect of LAs is primarily mediated by a potent inhibition of voltage-gated sodium channels. However, this effect is due to much more than the interaction of LAs with one single molecule. Most recent studies indicated that the development of selective local anesthetics might be possible and LAs also interact with several other membrane molecules. Although the relevance of these effects is still unclear, they might play a role in systemic analgesia, tissue protection and anti-inflammatory effects of LA. The therapeutic index of systemically applied LA is very narrow. Systemic application is formally not permitted because the impending systemic toxicity is still a life-threatening complication. Although the cardiac and central nervous toxicity at least partly result from an unselective block of neuronal and cardiac sodium channels, preclinical studies suggest the involvement of several mechanisms. A local LA toxicity is less clinically impressive; ...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

Related Links:

This study compared two commonly used approaches to ultrasound-guided brachial plexus regional anesthesia for upper limb surgery. What are the pros and cons of each?BMC Anesthesiology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news
The objective of the study is to describe the prognostic factors that would allow maintaining functionality at 12 months.MethodFrom June 1, 2010 to May 31, 2013, all patients older than 69 years with hip fracture due to bone fragility admitted to the Geriatric Acute Unit of our hospital were included. We define as functional maintenance those patients who have lost between 0 and 15 points in the Barthel Index with respect to the previous to the fracture. Prospective study of bivariate data analysis for related and multivariate prognostic factors for predictive predictors.Results271 patients were included, of them, 146 (54....
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
ConclusionsUnplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge.ResumenObjetivoLos procedimientos de Cirugía Ortopédica y Traumatología (COT) realizados en Unidades de Cirugía Mayor Ambulatoria (CMA) ofrecen importantes ventajas que desaparecen cuando la recuperación postoperatoria no es la...
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
Abstract PURPOSE: The purpose of this study was to investigate the reporting habits of clinicians who have been exposed to disruptive behaviour in the operating room (OR) and assess their satisfaction with management's responses to this issue. METHODS: Ethics committee approval was obtained. This was a pre-specified sub-study of a larger survey examining disruptive behaviour, which was distributed to OR clinicians in seven countries. Using Likert-style questions, this study ascertained the proportion of disruptive intraoperative behaviour that clinicians reported to management, as well as their degree of sati...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
CONCLUSION: As the results indicated a low adherence to international guidelines among the personnel, it is suggested that training courses should be provided to increase staff awareness on prevention and management of HAI. PMID: 31951688 [PubMed - in process]
Source: Central European Journal of Public Health - Category: International Medicine & Public Health Tags: Cent Eur J Public Health Source Type: research
Abstract The concentration of propofol in blood is an important indicator for anesthesiologists to monitor and regulate the anesthesia depth of patients during surgery. Herein, a negative photoionization ion mobility spectrometry with acetone as the dopant was developed for rapid and direct determination of intraoperative blood propofol concentration in the operating theatre. High concentration of acetone molecules in the carrier gas was used not only to enhance neutral desorption and release free propofol molecules from the whole blood, but also to increase the intensity of reactant O2- and reduce the amount of n...
Source: Analytica Chimica Acta - Category: Chemistry Authors: Tags: Anal Chim Acta Source Type: research
Authors: Rauya E, Sha O, Darwazeh R, Zhang BQ Abstract The current mainstay of screening and diagnosis for gastric diseases is conventional standard gastroscopy. However, it is invasive and uncomfortable procedure for the patients especially in case of non-sedative procedures and other adverse effects related to conscious sedation anesthesia. Recently, a magnetic guided capsule gastroscopy (MGCG) was introduced to overcome these challenges. It is a safe and pleasant procedure with no involvement of sedation and no risks of cross-infection between patients. In addition, this method is anticipated to be an alternativ...
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
Authors: Strieth S, Hagemann J, Hess M Abstract Transoral laser microsurgery (TLM) for treatment of laryngeal cancer has reduced temporary tracheotomies, increased organ preservation rates, and improved functional results. Gold standard for laser-based transoral resection of laryngeal cancer is the application of CO2 lasers. Oncologically safe radical resection and postoperative voice outcome must be weighed up individually. Angiolytic laser effects enable modification of the tumor micromilieu by targeted obliteration of microvessels and antagonization of angiogenesis with preservation of vibrating laryngeal tissue...
Source: HNO - Category: ENT & OMF Tags: HNO Source Type: research
Publication date: May 2020Source: Neurobiology of Stress, Volume 12Author(s): Delia Belelli, Derk Hogenkamp, Kelvin W. Gee, Jeremy J. LambertAbstractIn the 1980s particular endogenous metabolites of progesterone and of deoxycorticosterone were revealed to be potent, efficacious, positive allosteric modulators (PAMs) of the GABAA receptor (GABAAR). These reports were followed by the discovery that such steroids may be synthesised not only in peripheral endocrine glands, but locally in the central nervous system (CNS), to potentially act as paracrine, or autocrine “neurosteroid” messengers, thereby fine tuning ne...
Source: Neurobiology of Stress - Category: Neuroscience Source Type: research
This study evaluates parathyroidectomy outcomes in elderly patients.MethodsPrimary hyperparathyroidism patients having parathyroidectomy as listed in the 2005 –2017 ACS-NSQIP database were separated by age: ≤60, 61–79 and ≥80. Outcomes included complications, 30-day mortality, return to the OR, operating times, and hospital length of stay (LOS). Multivariable logistic regression was used to compare patients 61–79 and ≥80 to those ≤60. Patien ts ≤60 and ≥80 were propensity score matched using gender, race, BMI, smoking status, steroid use, modified frailty index (mFI), ASA class, procedur...
Source: World Journal of Surgery - Category: Surgery Source Type: research
More News: Anesthesia | Anesthesiology | Drugs & Pharmacology | Neurology | Study | Toxicology