REGIONAL
ANESTHESIA
Definition
Regional (local) anesthesia is the
reversible blockade of conduction by regionally injected agents, for the
purpose of sensory ablation. The examples are spinal and epidural caudal and
major nerve blocks.
Local
Anesthetic Agents
Local anesthetic agents act by
inducing a blockade of nerve transmission in peripheral nerve impulses. This
occurs as a result of obstruction to sodium channels in the axon membrane.
Local
anesthetic agents belong to one of two chemical classes according to their
structure.
Ester Class
The only ester still in frequent use
is cocaine, which is an ester of benzoic acid. It is used generally only for
topical anesthesia of mucous membranes in the nose and sinuses.
Amide Class
The first amide to be synthesized was lignocaine others are
listed in Table 4.3.
Anesthetics
Drugs
Local anesthetics
• Lignocaine
5%, heavy (hyperbaric)*
• Bupivacaine
(Marcaine) 0. 5% heavy, (hyperbaric)*
• Cinchocaine
(Nupercaine, Dibucaine, Sovacaine)0.5%, heavy (hyperbaric)
• Amethocaine
(Tetracaine, Pantocaine, Pontocaine, Decicain, Decicain Butethane, Anethaine)
1% solution prepared in saline, water or dextrose
• Mepivacaine
(Scandicaine, Carbocaine, Meaverin)-4% heavy (hyperbaric).
Other drugs*
available in India
• Vasopressors
• Metaraminol
(Aramine)
• Ephedrine
• Methoxamine (Vasoxine)
• Phenylephrine
• Noradrenaline/adrenaline
• Mephentermine.
Sterile cutting
file
Sterile drapes—Four
separate towels or a simple sheet with center eye hole.
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