Professional Documents
Culture Documents
03.11.2011
Contents
Introduction
Definition of local analgesia
Mechanism of action
Advantages and disadvantages of LA
General considerations
Desirable characters of local anesthetics
Pharmacokinetic of local anesthetics
Local anesthetics adjuvants and combinations
Local anesthetic toxicity
Common local anesthetic agents
Methods of local analgesia application
The subjects (classification) of anesthesia
4.Tranquilization &sedation
5.Narcosis
6.General anesthesia
Overview
Local anesthetics produce desensitization and analgesia of the
skin surface (topical anesthesia), tissues( infiltration and field
block) and regional structures( conduction anesthesia,
intravenous regional anesthesia)
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Resting Open
(Closed**) inactivated
(brief) LA have highest
affinity for the
Very slow inactivated form
repolarization in
presence of LA Refractory period
**Closed state may exist in various forms as it moves from resting to open. LA have a
high affinity for the different closed forms and may prevent them from opening.
Local analgesia
Advantages
Rapid onset
Ease to be sterilized
NONE totally meets these optimally yet!!
Local anesthetics
Local anesthetics can be divided chemically into two groups:
Protein binding
A. Absorption
1. Dose
Aminoester metabolism
Reducing toxicity
Increase intensity
systemic
allergic
A. Systemic toxicity
• This is most often the result of inadvertent and rapid
intravenous infusions producing a dose-dependent
continuum of effects on the brain and heart.
Central nervous system
Retarding absorption
1.Cocaine
the original local anesthetic (Isolated in 1860 from Coca leaves)
is the only one to cause vasoconstriction.
• extreme stability
• Available as:
– A transdermal preparation.
•Effective doses for peripheral nerve blocks and caudal epidural
anesthesia in horses typically do not exceed 0.2–0.3 mg/kg (i.e.
approximately 5–8 ml of the 2% solution in an average adult horse).
•Doses for peripheral nerve blocks and caudal epidural anesthesia are
in the range 0.05–0.08 mg/kg (i.e. 5–8 ml of the 0.5% solution in an
average adult horse).
Not effective topically.
is more toxic than procaine, but concentrations for epidural block and
surface analgesia are lower (0.5%).
It is non-irritant
Analgesia.
Anti-inflammatory actions.
MAC is the concentration of the vapour in the lungs that is needed to
prevent movement (motor response) in 50% of subjects in response
to surgical (pain) stimulus.
Physiological effects of intravenous lidocaine cont…..
Anti-dysrhythmogenic effect.
A. CNS effects
Vasodilation.
Cardiac dysrhythmias.
Treatment
) Intrasynovial anesthesia.
e Infiltration anesthesia.
intrasynovial analgesia
Instillation analgesia
Indications:
Examination of the eye
Removal of foreign bodies
Conjunctival scraping
Removal of hypertrophied glands of the third eyelid
Subconjunctival injection
Topical anesthetics for instillation:
Lidocaine 2-5% ,Proparacaine 0.5%
Tetracaine 0.5%, Butacaine 0.5%
It gives 15 min anesthesia after single instillation and 2hrs after
3-5 series of instillation with one min intervals.
Intrasynovial analgesia
Indications
Diagnosis of lameness caused by joint disorder
To relief pain caused by arthritis
Technique
Preparation of the site of arthrocentesis for aseptic injection
The onset of effect begin after 10 min and persist for 60 min.
3.Infiltration anesthesia
1. By this method the nerve endings are affected at the actual site
of operation.
Indications
Disadvantages
3.field block
4.Ring block
1.linear infiltration
Preparation of the area to be anaesthetized for aseptic
interference.
Needle: 18 G, 7-10 cm
7-high cost
Advantages: -
Site : a line along the caudal border of the last rib and a long
a line ventral to the lumber transverse process from the last
rib to the 4th lumber vertebra.
Needle: 18 G, 7 cm