background: direct thrombin inhibitors and factor xa inhibitors are gaining popularity as alternatives to warfarin for patients requiring anticoagulation. toxicity due to these medications is difficult to manage because overdose experience is very limited and there is no clear guidance on when or whether to use antidote in this setting. case presentation: a 50-year-old man with normal renal fun...

Selective nerve root blocks (SNRB) have been used for many years as a diagnostic tool in patients with low back pain with radicular symptoms. However the accuracy, specificity, and sensitivity of these blocks has been questioned as a screening tool for spine surgery. The utility of current SNRB techniques relies primarily on the relief of pain when local anesthetic is injected. However, patient...

BACKGROUND AND OBJECTIVES The bispectral index (BIS) is a multifactorial parameter derived from the electroencephalogram (EEG), which allows monitoring of the hypnotic component of anesthesia. It was obtained from the algorithm based on the analysis of a large number of EEGs from volunteers and patients undergoing sedation and general anesthesia with different anesthetic agents. The use of BIS ...

A relatively large group of compounds, which includes local anesthetics, antiarrhythmics, and anticonvulsants induce voltage-and/or frequency-dependent block of sodium and other ion channels. Current block increases as the stimulus voltage and frequency of depo-larization is increased. These voltage-and frequency-dependent blocking properties have been recognized for over 40 yr (Weidmann, 1955)...

  Clonidine, an α2-adrenergic receptor agonist not only induces analgesia but also prolongs the effects of local anesthetic substances. In the present study the effects of clonidine on spontaneous and formalin-induced electrical activity from dorsal skin nerve were investigated. The results showed that clonidine (0.5 mM) decreased the formalin effect on electrical nerve activity whereas clonidi...

Hundreds of substances possess anesthetic action. However, despite decades of research and tests, a golden rule is required to reconcile the diverse hypothesis behind anesthesia. What makes an anesthetic to be local or general in the first place? The specific targets on proteins, the solubility in lipids, the diffusivity, potency, action time? Here we show that there could be a new player equal...

OPICAL ANESTHESIA REPRESENTS A T c o m m o d y used anesthetic technique for a variety of endoscopic procedures.'4 In general, local anesthesia for endoscopy is a safe and effective procedure.g However, it has been shown that certain local anesthetics, such as tetracaine, are rapidly absorbed from the mucous membranes of the respiratory tract and can lead to severe toxic effects in man.' Thus, ...

PURPOSE A laboratory investigation was undertaken to compare the in vivo antinociceptive effects of 2% liposomal formulations of prilocaine (PLC), lidocaine (LDC) and mepivacaine (MVC) compared to plain solutions of each of these three local anesthetics. METHODS Large unilamellar vesicles were prepared by extrusion (400 nm), at pH 7.4. The membrane/water partition coefficients were obtained f...

Objectives: This study was carried out to study the efficacy and the anesthetic characters of using Articaine 4 % with 1:100,000 Epinephrine as a local anesthetic drug in surgical practice through inferior alveolar nerve block and comparing it with Lidocaine 2% with 1:100,000 Epinephrine. Materials and methods: Thirty patients in two groups, fifteen patients each, undergo extraction of impacted...

BACKGROUND Local anesthetic injection is often cited in literature as the most painful part of minor procedures. It is also very possible for all doctors to get better at giving local anesthesia with less pain for patients. The purpose of this article is to illustrate and simplify how to inject local anesthesia in an almost pain-free manner. METHODS The information was obtained from reviewing...