medication given that causes a loss of sensation.
when a client or patient loses sensation to a limited part of their body (i.e. mouth, arm) without losing consciousness.
Used when brief dental or medical procedures are performed.
Five major routes are used for applying local anesthetics:
Topical (surface) anesthesia
Nerve Block anesthesia
applied to mucous membrane (+ eyes, lips, gums, throat, nasal membranes)
direct injection into tissue to block a specific group of nerves near to the surgical site.
Spinal anesthesia (Local anesthesia)
Epidural anesthesia (local anesthesia)
MOA: prevent entry of Na+ ions into cells of the nervous system, thus producing a numbing effect, diminish sensation and muscle activity in that area.FYI: Adding small amounts of Epinephrine to the anesthetic solution extends the DOA of injectable local anesthetics. It causes a Vasoconstriction effect, allowing the anesthetic to stay there longer
Local anesthesia - Esters - short or moderate duration of action (DOA) "AINE"
b. Procaine (Novocain®)
c. Benzocaine (Solarcaine®)
Local anesthesia - Amides - longer DOA "AINE"
a. Lidocaine (Xylocaine®) Lidocaine + Epi extends time 15-20 minutes ® 45-60 minute
Bacteria can acidify infected site, therefore, adding sodium hydroxide or sodium
bicarbonate (alkaline substance) will neutralize the region for a basic environment
b. Prilocaine (Citanest®)
c. Mepivacaine (Carbocaine®)
d. Etidocaine (Duranest®)
e. Bupivacaine (Marcaine®)
Local anesthesia - Adverse effects/ Side effects of Esters/Amides
NOTE: These side effects are lessened with Amides
medication that causes loss of sensation to entire body, usually results in a loss of consciousness.
- Provides a rapid and complete loss of sensation for a long period of time.
- Signs include loss of pain, consciousness, memory, and body movement.
- G. A. depresses all nervous activity in the brain.
General anesthesia - Stages
Stage 1: loss of pain. proceeds until the patient loses consciousness.
Stage 2: calming agents stage. Excitement & hyperactivity, increased HR, breathing, BP
Stage 3: surgery stage. Surgical Anethesia, skeletal muscles become relaxed. Eye movement slows down,patient becomes very still
Stage 4: paralysis of the medulla region in the brain, death could result, should be avoided, administered as IV or inhaled (gases or volatile agents)
General anesthesia - Long Procedures
1. IV agents administered
2. After patient loses consciousness, inhaled agents are given to maintain anesthesia.
Concurrent administration of IV and inhaled drugs allows the dose of inhaled anesthetics to be reduced, thus decreasing side effects.
General anesthesia - Short Procedures
1. IV agents only used
MOA: proposed, not known
· Prevents the flow of sodium into neurons
· GABA Receptors become activated to receive NT
· No receptor binding
· No effect on neurotransmitter release.
General anesthesia - IV anesthetics
also used to relax muscles and reduce pain (analgesic)
Thiopental sodium (Pentothal®): reduces HR
General anesthesia - Inhaled anesthetics "ANE"
Nitrous oxide – gases (laughing gas)- anxiety
- when exhaling ® patient may experience difficulty breathing
- abused by HCW due to relax sedated stateHalothane (Fluothane®) – volatile agent
- cardiac dysrhythmia (bradycardia)
- reduces blood pressure
- reduces respiratory rate
Insoflurane (Forane®)*most used due to less side effectsy
-Atropine, anti-cholinergics are used to reverse bradycardia caused by some anesthetics.
-anit-emetic- Promethazine (Phenergan)-Bethanocal (Urecholine)