Local anesthetic - Knowledge (XXG)

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Once inside the cell, the local anesthetic will be in equilibrium, with the formation of the protonated (ionized) form, which does not readily pass back out of the cell. This is referred to as "ion-trapping". In the protonated form, the molecule binds to the LA binding site on the inside of the ion channel near the cytoplasmic end. Most LAs work on the internal surface of the membrane - the drug has to penetrate the cell membrane, which is achieved best in the nonionised form. This is exemplified by the permanently ionised LA

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tissue swelling at the point of injection. This is due to puncturing of the vein which allows the blood to flow into loose tissues in the surrounding area. Blanching of the tissues in the area where the local anesthetic is deposited is also common. This gives the area a white appearance as the blood flow is prevented due to vasoconstriction of arteries in the area. The vasoconstriction stimulus gradually wears off and subsequently the tissue returns to normal in less than two hours.

1163:(Bier's block) is when blood circulation of a limb is interrupted using a tourniquet (a device similar to a blood-pressure cuff), then a large volume of LA is injected into a peripheral vein. The drug fills the limb's venous system and diffuses into tissues, where peripheral nerves and nerve endings are anesthetized. The anesthetic effect is limited to the area that is excluded from blood circulation and resolves quickly once circulation is restored. 303:, conduction anesthesia may be preferable because of superior pain control and fewer side effects. For purposes of pain therapy, LA drugs are often given by repeated injection or continuous infusion through a catheter. LA drugs are also often combined with other agents such as opioids for synergistic analgesic action. Low doses of LA drugs can be sufficient so that muscle weakness does not occur and patients may be mobilized. 6814: 5308: 5329: 751:. The effects of local anesthetics are, therefore, not specific for the signal conduction in peripheral nerves. Side effects on the central nervous system and the heart may be severe and potentially fatal. However, toxicity usually occurs only at plasma levels which are rarely reached if proper anesthetic techniques are adhered to. High plasma levels might arise, for example, when doses intended for 6824: 1716: 1800:

introducing it to animal or human experimentation. The Vienna school first started using cocaine as local anaesthesia in ophthalmology and it was later incorporated into ophthalmologic practice. Dr. Halsted and Dr. Hall, in the United States in 1885 described an intraoral anesthetic technique of blocking the inferior alveolar nerve and the antero-superior dental nerve using 4% cocaine.{

1644: 1575: 1416:. Because the vasoconstrictor temporarily reduces the rate at which the systemic circulation removes the local anesthetic from the area of the injection, the maximum doses of LAs when combined with a vasoconstrictor is higher compared to the same LA without any vasoconstrictor. Occasionally, cocaine is administered for this purpose. Examples include: 1319: 1505: 888:, and does not result in cross-allergy to amides. Therefore, amides can be used as alternatives in those patients. Nonallergic reactions may resemble allergy in their manifestations. In some cases, skin tests and provocative challenge may be necessary to establish a diagnosis of allergy. Also cases of allergy to 1074:, thus interruption of only consecutive nodes of Ranvier will prevent action potential propagation. In turn, in unmyelinated nerves, an entire length needs to be blocked. Regarding diameter, the generally accepted principle is that susceptibility to local anesthesia depends inversely on fiber diameter. 1822:

published his article "Anestesia Metamérica". This technique was popularized in the 1930s and 1940s by Achile Mario Dogliotti. With the advent of thin, flexible catheters, continuous infusion and repeated injections have become possible, making epidural anesthesia still a highly successful technique.

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Gow-Gates technique is used to provide anesthetics to the mandible of the patient's mouth. With the aid of extra and intraoral landmarks, the needle is injected into the intraoral latero-anterior surface of the condyle, steering clear below the insertion of the lateral pterygoid muscle. The extraoral

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and are usually formulated as the hydrochloride salt to render them water-soluble. At a pH equal to the protonated base's pKa, the protonated (ionized) and unprotonated (unionized) forms of the molecule exist in equimolar amounts, but only the unprotonated base diffuses readily across cell membranes.

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cannot arise and signal conduction is inhibited. The receptor site is thought to be located at the cytoplasmic (inner) portion of the sodium channel. Local anesthetic drugs bind more readily to sodium channels in an activated state, thus onset of neuronal blockade is faster in rapidly firing neurons.

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In comparison to other regional block methods of anestheising the lower jaw, the Gow-Gates technique has a higher success rate in fully anesthetising the lower jaw. One study found that out of 1,200 patients receiving injections through the Gow-Gates technique, only 2 of them did not obtain complete

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C-CLADs (computer controlled local anesthetic delivery devices) can be used. Its usage of computer microprocessors allows for control of fluid dynamics and anesthetic deposition. This minimizes subjective flow rates and variability in pressure. This thereby results in enhanced hydrodynamic diffusion

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Local anesthetics can block almost every nerve between the peripheral nerve endings and the central nervous system. The most peripheral technique is topical anesthesia to the skin or other body surface. Small and large peripheral nerves can be anesthetized individually (peripheral nerve block) or in

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Although lipid rescue mechanism of action is not completely understood, the added lipid in the blood stream may act as a sink, allowing for the removal of lipophilic toxins from affected tissues. This theory is compatible with two studies on lipid rescue for clomipramine toxicity in rabbits and with

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During pregnancy, it is not common for local anesthetics to have any adverse effect on the fetus. Despite this, risks of toxicity may be higher in pregnancy due to an increase in unbound fraction of local anesthetic and physiological changes increase the transfer of local anesthetic into the central

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Edema of tongue, pharynx and larynx may develop as a side effect of local anesthesia. This could be caused by a variety of reasons including trauma during injection, infection, an allergic reaction, haematoma or injection of irritating solutions such as cold-sterilization solutions. Usually there is

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Disadvantages: Risk of temporary periodontal tissue damage, likelihood of bacteriemia and endocarditis for at-risk populations, appropriate pressure and correct needle placement are imperative for anesthetic success, short duration of pulpal anesthesia limits the use of ILIs for several restorative

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Advantages of ILI over INAB: rapid onset (within 30 seconds), small dosage required (0.2–1.0 mL), limited area of numbness, lower intrinsic risks such as neuropathy, hematoma, trismus/jaw sprain and self-inflicted periodontal tissue injury, as well as decreased cardiovascular disturbances. Its

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Dental needles are available in two lengths, short and long. As Vazirani–Akinosi is a local anesthetic technique which requires penetration of a significant thickness of soft tissues, a long needle is used. The needle is inserted into the soft tissue which covers the medial border of the mandibular

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Permanent nerve damage after a peripheral nerve block is rare. Symptoms are likely to resolve within a few weeks. The vast majority of those affected (92–97%) recover within four to six weeks; 99% of these people have recovered within a year. An estimated one in 5,000 to 30,000 nerve blocks results

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Local anesthetics and vasoconstrictors may be administered to pregnant patients however it is very important to be extra cautious when giving a pregnant patient any type of drug. Lidocaine can be safely used but bupivacaine and mepivacaine should be avoided. Consultation with the obstetrician

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Giving local anesthesia to patients with liver disease can have significant consequences. Thorough evaluation of the disease should be carried out to assess potential risk to the patient as in significant liver dysfunction, the half-life of amide local anesthetic agents may be drastically increased

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Application of local anesthetics during oocyte removal during in vitro fertilization has been up to debate. Pharmacological concentrations of anesthetic agents have been found in follicular fluid. Clinical trials have not concluded any effects on pregnant women. However, there is some concern with

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Cardiac toxicity can result from improper injection of agent into a vessel. Even with proper administration, it is inevitable for some diffusion of agent into the body from the site of application due to unforeseeable anatomical idiosyncrasies of the patient. This may affect the nervous system or

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while inhibiting the orthosympathetic nervous system. What results is a dilation of arteries in muscles which can lead to a reduction in circulating blood volume inducing a temporary shortness of blood flow to the brain. Notable symptoms include restlessness, visibly looking pale, perspiration and

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Spinal anesthesia was first used in 1885, but not introduced into clinical practice until 1899, when August Bier subjected himself to a clinical experiment in which he observed the anesthetic effect, but also the typical side effect of postpunctural headache. Within a few years, spinal anesthesia

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Biophysical forces (pulsation of the maxillary artery, muscular function of jaw movement) and gravity will aid with the diffusion of anesthetic to fill the whole pterygomandibular space. All three oral sensory parts of the mandibular branch of the trigeminal nerve and other sensory nerves in the

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The Vazirani–Akinosi technique is also known as the closed-mouth mandibular nerve block. It is mostly used in patients who have limited opening of the mandible or in those that have trismus; spasm of the muscles of mastication. The nerves which are anesthetised in this technique are the inferior

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Intraligamentary infiltration, also known as periodontal ligament injection or intraligamentary injection (ILI), is known as "the most universal of the supplemental injections". ILIs are usually administered when inferior alveolar nerve block techniques are inadequate or ineffective. ILIs are

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Shortly after the first use of cocaine for topical anesthesia, blocks on peripheral nerves were described. Brachial plexus anesthesia by percutaneous injection through axillary and supraclavicular approaches was developed in the early 20th century. The search for the most effective and least

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The invention of clinical use of local anaesthesia is credited to the Vienna School which included Sigmund Freud (1856-1939), Carl Koller (1857-1944) and Leopold Konigstein (1850–1942). They introduced local anaesthesia, using cocaine, through 'self-experimation' on their oral mucosa before

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For most patients, administration of local anesthetics causes the sensation of pain to be lost first, followed by temperature, touch, deep pressure, and finally motor function. The sensitivity of nerve fibers to blockade depends on a combination of diameter and myelination. Their different

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Ample supporting animal evidence and human case reports show successful use of lipid rescue in this way. In the UK, efforts have been made to publicize lipid rescue more widely. In 2010, lipid rescue had been officially promoted as a treatment of local anesthetic toxicity by the

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The intraligamentary syringe offers mechanical advantage by using a trigger-grasp or click apparatus to employ a gear or lever that improves control and results in increased force to push the anesthetic cartridge's rubber stopper forward for medication deposition with greater

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Aggarwal V, Singla M, Miglani S, Kohli S, Sharma V, Bhasin SS (January 2018). "Does the volume of supplemental intraligamentary injections affect the anesthetic success rate after a failed primary inferior alveolar nerve block? A randomized-double blind clinical trial".

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for the patient's comfort and ease of surgery. However, many anesthetists, surgeons, patients and nurses believe that it is safer to perform major surgeries under local anesthesia than general anesthesia. Typical operations performed under conduction anesthesia include:

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Hence, it is crucial for the medical professional administrating the local anesthesia, especially in the form of an injection, to ensure that the patient is in a comfortable setting and has any potential fears alleviated in order to avoid these possible complications.

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Transincision (or transwound) catheter anesthesia uses a multilumen catheter inserted through an incision or wound and aligned across it on the inside as the incision or wound is closed, providing continuous administration of local anesthetic along the incision or

711:, swelling and/or discolouration of the region. The density of tissues surrounding the injured vessels is an important factor for haematoma. There is greatest chance of this occurring in a posterior superior alveolar nerve block or in a pterygomandibular block. 1382:, while amide LAs are metabolized in the liver. This can be a factor in choosing an agent in patients with liver failure, although since cholinesterases are produced in the liver, physiologically (e.g. very young or very old individual) or pathologically (e.g. 1060:

Acidosis such as caused by inflammation at a wound partly reduces the action of LAs. This is partly because most of the anesthetic is ionized and therefore unable to cross the cell membrane to reach its cytoplasmic-facing site of action on the sodium channel.

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The needle is inserted along the long axis, at a 30 degree angle, of the mesial or distal root for single rooted teeth and on the mesial and distal roots of multi-rooted teeth. Bevel orientation toward the root provides easier advancement of the needle

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is a complex and often serious condition that requires diagnosis and treatment by an expert in pain medicine. LAs can be applied repeatedly or continuously for prolonged periods to relieve chronic pain, usually in combination with medication such as

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Sirianni AJ, Osterhoudt KC, Calello DP, Muller AA, Waterhouse MR, Goodkin MB, et al. (April 2008). "Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine".

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became widely used for surgical anesthesia and was accepted as a safe and effective technique. Although atraumatic (noncutting-tip) cannulae and modern drugs are used today, the technique has otherwise changed very little over many decades.

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ramus, in region of the inferior alveolar, lingual and mylohyoid nerves. The positioning of the bevel of the needle is very important as it must be positioned away from the bone of the mandibular ramus and instead towards the midline.

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ILI utilization is expected to increase because dental patients prefer fewer soft tissue anesthesia and dentists aim to reduce administration of traditional inferior alveolar nerve block (INAB) for routine restorative procedures.

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in extremities such as the nose, ears, fingers, and toes (due to constriction of end arteries), is invalidated, since no case of necrosis has been reported since the introduction of commercial lidocaine with epinephrine in 1948.

959:, a commonly available intravenous lipid emulsion, can be effective in treating severe cardiotoxicity secondary to local anesthetic overdose, including human case reports. However, the evidence at this point is still limited. 617:

Diagnostic tests such as bone marrow aspiration, lumbar puncture (spinal tap) and aspiration of cysts or other structures are made to be less painful upon administration of local anesthetic before insertion of larger needles.

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Kampe S, Warm M, Kasper SM, Diefenbach C (July 2003). "Concept for postoperative analgesia after pedicled TRAM flaps: continuous wound instillation with 0.2% ropivacaine via multilumen catheters. A report of two cases".

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traumatic approach for plexus anesthesia and peripheral nerve blocks continues to this day. In recent decades, continuous regional anesthesia using catheters and automatic pumps has evolved as a method of pain therapy.

1131:, often inside a tissue compartment that limits the diffusion of the drug away from the intended site of action. The anesthetic effect extends to the innervation areas of several or all nerves stemming from the plexus. 2028:

Ryan T, Hodge A, Holyoak R, Vlok R, Melhuish T, Binks M, et al. (July 2019). "Tramadol as an adjunct to intra-articular local anesthetic infiltration in knee arthroscopy: a systematic review and meta-analysis".

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Berlin J, Nusstein J, Reader A, Beck M, Weaver J (March 2005). "Efficacy of articaine and lidocaine in a primary intraligamentary injection administered with a computer-controlled local anesthetic delivery system".

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Injection methodology: The periodontal ligament space provides an accessible route to the cancellous alveolar bone, and the anesthetic reaches the pulpal nerve via natural perforation of intraoral bone tissue.

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At higher concentrations, a relatively selective depression of inhibitory neurons results in cerebral excitation, which may lead to more advanced symptoms include motor twitching in the periphery followed by

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Virtually every part of the body can be anesthetized using conduction anesthesia. However, only a limited number of techniques are in common clinical use. Sometimes, conduction anesthesia is combined with

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Shabazfar N, Daubländer M, Al-Nawas B, Kämmerer PW (2014). "Periodontal intraligament injection as alternative to inferior alveolar nerve block--meta-analysis of the literature from 1979 to 2012".

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Local anesthesia is also used during insertion of IV devices, such as pacemakers and implantable defibrillators, ports used for giving chemotherapy medications and hemodialysis access catheters.

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Froum SJ, Tarnow D, Caiazzo A, Hochman MN (September 2000). "Histologic response to intraligament injections using a computerized local anesthetic delivery system. A pilot study in mini-swine".

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Withdraw needle for minimally 10–15 seconds to permit complete deposition of solution. This can be slower than other injections as there is pressure build-up from the anesthetic administration.

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When patients are emotionally affected in the form of nervousness or fear, it can lead to vasovagal collapse. This is the anticipation of pain during administration that activates the

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in 1904. Since then, several synthetic local anesthetic drugs have been developed and put into clinical use, notably lidocaine in 1943, bupivacaine in 1957, and prilocaine in 1959.

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is a method of toxicity treatment was invented by Dr. Guy Weinberg in 1998, and was not widely used until after the first published successful rescue in 2006. Evidence indicates

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Litz RJ, Popp M, Stehr SN, Koch T (August 2006). "Successful resuscitation of a patient with ropivacaine-induced asystole after axillary plexus block using lipid infusion".

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Surface anesthesia is the application of an LA spray, solution, or cream to the skin or a mucous membrane; the effect is short lasting and is limited to the area of contact.

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Epidural anesthesia by a caudal approach had been known in the early 20th century, but a well-defined technique using lumbar injection was not developed until 1921, when

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of solution into bone or the target area of deposition, thus permitting larger amounts of anesthetic solution to be delivered during ILIs without increased tissue damage.

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General systemic adverse effects are due to the pharmacological effects of the anesthetic agents used. The conduction of electric impulses follows a similar mechanism in

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roots; depending on the site of injection and the volume injected, the anesthetized area varies from limited areas of the abdomen or chest to large regions of the body.

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was first used as a local anesthetic in 1884. The search for a less toxic and less addictive substitute led to the development of the aminoester local anesthetics

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as a local anesthetic in addition to its stimulant properties. It was also used for slave payment and is thought to play a role in the subsequent destruction of

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Blanching of the tissue is observed and may be more evident when vasoconstrictors are used. It is caused by a temporary obstruction of blood flow to the tissue.

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Injection of LAs is often painful. A number of methods can be used to decrease this pain, including buffering of the solution with bicarbonate and warming.

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can produce this effect, especially benzocaine. The systemic toxicity of prilocaine is comparatively low, but its metabolite, o-toluidine, is known to cause

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D'Souza JE, Walton RE, Peterson LC (March 1987). "Periodontal ligament injection: an evaluation of the extent of anesthesia and postinjection discomfort".

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landmarks used for this technique are the lower border of the ear tragus, corners of the mouth and the angulation of the tragus on the side of the face.

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during restorative operations such as fillings, crowns, and root canals, or extractions, and regional nerve blocks during extractions and surgeries

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Brown AR, Weiss R, Greenberg C, Flatow EL, Bigliani LU (1993). "Interscalene block for shoulder arthroscopy: comparison with general anesthesia".

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Hochman MN, Friedman MJ, Williams W, Hochman CB (June 2006). "Interstitial tissue pressure associated with dental injections: a clinical study".

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The duration of soft tissue anesthesia is longer than pulpal anesthesia and is often associated with difficulty eating, drinking and speaking.

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sensitivities to LA blockade is termed differential blockade. Myelinated fibers are more sensitive to blockade as they are interrupted by

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nervous system. Hence, it is recommended that pregnant women use a lower dose of local anesthetic to reduce any potential complications.

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Depending on local tissue concentrations of local anesthetics, excitatory or depressant effects on the central nervous system may occur.

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Weinberg G, Ripper R, Feinstein DL, Hoffman W (2003). "Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity".

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procedures that require longer duration, postoperative discomfort, and injury on unerupted teeth such as enamel hypoplasia and defects.

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rhythms, and eventual cardiovascular collapse. Although all local anesthetics potentially shorten the myocardial refractory period,

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There is risk of accidental damage to local blood vessels during injection of the local anesthetic solution. This is referred to as

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Local anesthetics may be used to prevent and/or treat acute pain, to treat chronic pain, and as a supplement to general anesthesia.

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Smith GN, Walton RE, Abbott BJ (December 1983). "Clinical evaluation of periodontal ligament anesthesia using a pressure syringe".

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across the cell membrane but, if injected into the cytosol of a nerve fibre, can induce NaKATPase blockage and anesthetic effects.

806:. It is reported that seizures are more likely to occur when bupivacaine is used, particularly in combination with chloroprocaine. 79:. Local anesthetics are most commonly used to eliminate pain during or after surgery. When it is used on specific nerve pathways ( 6550: 6228: 1811:

in 1908. This technique is still in use and is remarkably safe when drugs of low systemic toxicity such as prilocaine are used.

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Walton RE, Garnick JJ (January 1982). "The periodontal ligament injection: histologic effects on the periodontium in monkeys".

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Besides its many uses for surgery, epidural anesthesia is particularly popular in obstetrics for the treatment of labor pain.

1326:. A cartridge of LA fits into the disposable needle, which can be locked when not in use and can be separated from the handle. 6774: 6733: 6380: 3110: 2451: 2371: 1737: 1098:

anatomic nerve bundles (plexus anesthesia). Spinal anesthesia and epidural anesthesia merge into the central nervous system.

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Administration of soft tissue anesthesia is recommended prior to ILI administration. This helps to enhance patient comfort.

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Harvey M, Cave G (February 2007). "Intralipid outperforms sodium bicarbonate in a rabbit model of clomipramine toxicity".

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Malamed SF (February 1982). "The periodontal ligament (PDL) injection: an alternative to inferior alveolar nerve block".

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Endocrine and metabolic systems only have slightly adverse effects with most cases being without clinical repercussions.

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For its success, the anesthetic must be administered under pressure. It must not leak out of the sulcus into the mouth.

6621: 6286: 5710: 5177: 2596:"Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats" 2740:"Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest" 3736:

Roberts GJ, Holzel HS, Sury MR, Simmons NA, Gardner P, Longhurst P (January 1997). "Dental bacteremia in children".

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Galili D, Kaufman E, Garfunkel AA, Michaeli Y (December 1984). "Intraligamentary anesthesia--a histological study".

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Mulroy MF (2002). "Systemic toxicity and cardiotoxicity from local anesthetics: incidence and preventive measures".

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region will come in contact with the anesthetic and this reduces the need to anesthetise supplementary innervation.

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All plaque and calculus to be eradicated, optimally before the operative visit to assist gingival tissue healing.

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of LA into the tissue to be anesthetized; surface and infiltration anesthesia are collectively topical anesthesia

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Picard J, Meek T (February 2006). "Lipid emulsion to treat overdose of local anesthetic: the gift of the glob".

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usage as a secondary or supplementary anesthesia on the mandible has reported a high success rate of above 90%.

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Heavner, James E. (2017). Longnecker, David E.; Mackey, Sean C.; Newman, Mark F.; Sandberg, Warren S. (eds.).

1378:. The names of each locally clinical anesthetic have the suffix "-caine". Most ester LAs are metabolized by 836:

Cardiac toxicity associated with overdose of intravascular injection of local anesthetic is characterized by

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The side effects of inferior alveolar nerve block include feeling tense, clenching of the fists and moaning.

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Henkel G (December 2001). "Susceptibility of Nerve Fibers to Local Anesthesia:"Size Principle" Challenged".

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Many local anesthetics fall into two general chemical classes, amino esters (top) and amino amides (bottom).

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is a process where iron in hemoglobin is altered, reducing its oxygen-carrying capability, which produces

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is injection of LA in the vicinity of a peripheral nerve to anesthetize that nerve's area of innervation.

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possible loss of consciousness. In severe cases, clonic cramps resembling an epileptic insult may occur.

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Though most case reports to date have recorded most common use of Intralipid, other emulsions, such as

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spinal anaesthesia or epidural anesthesia, peripheral nerve blocks, or intravenous regional anesthesia

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ILIs should not be administered at tooth sites with 5 mm or more of periodontal attachment loss.

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are very rare. Allergic reactions to the esters is usually due to a sensitivity to their metabolite,

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Field block is subcutaneous injection of an LA in an area bordering on the field to be anesthetized.

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cause the agent to enter into general circulation. However, infections are very seldom transmitted.

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Most naturally occurring local anesthetics with the exceptions of menthol, eugenol and cocaine are

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A profound depression of brain functions may occur at even higher concentrations which may lead to

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Local anesthesia of body cavities includes intrapleural anesthesia and intra-articular anesthesia.

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Kaufman E, Galili D, Garfunkel AA (March 1983). "Intraligamentary anesthesia: a clinical study".

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Anesthetic deposition is recommended at 0.2 mL, per root or site, over minimally 20 seconds.

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When the needle reaches between the root and crestal bone, significant resistance is experience.

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Adverse reactions to local anesthetics (especially the esters) are not uncommon, but legitimate

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On the other hand, fear of administration can also result in accelerated, shallow breathing, or

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The risk of temporary or permanent nerve damage varies between different locations and types of

5562: 1017:). Though many other drugs also have membrane-stabilizing properties, not all are used as LAs ( 6672: 6499: 6494: 6385: 6312: 6218: 5956: 5946: 5283: 5066: 5056: 4959: 4789: 4745: 4729: 4533: 4523: 4466: 4456: 4276: 4207: 4180: 4137: 4088: 4046: 4011: 3975: 3939: 3912: 3869: 3831: 3796: 3753: 3715: 3680: 3663:

Walton RE, Abbott BJ (October 1981). "Periodontal ligament injection: a clinical evaluation".

3645: 3610: 3540: 3505: 3470: 3443: 3392: 3357: 3304: 3269: 3234: 3224: 3201: 3118: 3089: 3059: 3020: 2979: 2922: 2856: 2835:"Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review" 2807: 2761: 2709: 2663: 2617: 2559: 2494: 2457: 2417: 2336: 2326: 2300: 2290: 2264: 2256: 2217: 2182: 2130: 2089: 2046: 1965: 1947: 924: 908: 900: 550: 538: 532: 479: 4071:

Gow-Gates GA (April 1998). "The Gow-Gates mandibular block: regional anatomy and analgesia".

963: 6662: 6451: 6411: 6124: 5992: 5758: 5293: 5116: 5041: 4954: 4820: 4699: 4488: 4266: 4170: 4080: 4038: 4003: 3967: 3904: 3861: 3823: 3788: 3745: 3707: 3672: 3637: 3602: 3575: 3532: 3497: 3433: 3423: 3384: 3349: 3296: 3261: 3193: 3147: 3051: 3010: 2971: 2940: 2914: 2846: 2799: 2751: 2701: 2655: 2607: 2486: 2248: 2209: 2172: 2120: 2081: 2038: 1955: 1939: 1409: 1071: 1045: 1037: 853: 776: 502: 242:

Topical administration of cream, gel, ointment, liquid, or spray of anesthetic dissolved in

229: 136: 68: 1462:

One combination product of this type is used topically for surface anaesthesia, TAC (5–12%

852:

blocks the cardiac sodium channels, thereby making it most likely to precipitate malignant

6416: 6291: 6251: 5970: 5599: 5521: 5458: 5453: 5333: 5278: 5147: 5142: 4981: 4914: 4909: 4795: 4741: 4582: 4473: 4426: 2014: 1606: 1530: 1365: 1340: 1246:

Needle gauges of sizes 27-gauge short or 30-gauge ultra-short needle are usually utilized.

1010: 997:

a clinical report on the use of lipid rescue in veterinary medicine to treat a puppy with

857: 516: 283: 129: 76: 1784:

when Spaniards realized the effects of chewing the coca leaves and took advantage of it.

892:

derivatives occur, which are often added as preservatives to local anesthetic solutions.

3287:

Blanton PL, Jeske AH (June 2003). "The key to profound local anesthesia: neuroanatomy".

6524: 6519: 6431: 6086: 6036: 5858: 5704: 5483: 5433: 5312: 5212: 5207: 5061: 5051: 5001: 4986: 4976: 4877: 4872: 4862: 4800: 4772: 4724: 4719: 4451: 4406: 4402: 4255:"Local anaesthesia through the action of cocaine, the oral mucosa and the Vienna group" 4175: 4158: 4084: 3438: 3411: 1960: 1927: 1819: 1773: 1520: 1346: 1135: 979: 382: 170: 3908: 3641: 3606: 3197: 2975: 2918: 2213: 6842: 6646: 6534: 6436: 6261: 6022: 5920: 5916: 5878: 5874: 5813: 5809: 5773: 5608: 5526: 5244: 5217: 5076: 4894: 4805: 4785: 4781: 4644: 4572: 4461: 4376: 3827: 3792: 3353: 3265: 3151: 3055: 3015: 2998: 2851: 2834: 2803: 2756: 2739: 2705: 2612: 2595: 2085: 1699: 1695: 1360: 1033: 756: 650: 271: 3711: 3676: 3579: 3388: 3300: 2819: 2773: 2721: 2506: 2058: 1928:"Experience with nalbuphine, a new opioid analgesic, in acute myocardial infarction" 142:

The suffix "-caine" at the ends of these medication names is derived from the word "

6509: 6337: 6322: 5951: 5762: 5503: 5473: 5438: 5386: 5202: 5121: 4857: 4815: 4649: 4639: 4555: 4550: 3881: 3765: 3552: 2675: 2629: 1664: 1659: 1647: 1557: 1546: 1535: 1371: 1356: 1150: 1139: 1128: 661: 634: 590: 564: 457: 453: 369: 133: 4760: 4007: 2382: 719:

is vital before administering any type of local anesthetic to a pregnant patient.

17: 4130: 2594:

Weinberg GL, VadeBoncouer T, Ramaraju GA, Garcia-Amaro MF, Cwik MJ (April 1998).

2252: 1157:; the resulting anesthesia usually extends from the legs to the abdomen or chest. 820:

Another possibility is direct exposure of the central nervous system through the

128:

Synthetic cocaine-derived LAs differ from cocaine because they have a much lower

6713: 6421: 6375: 6163: 6051: 6006: 5966: 5924: 5886: 5870: 5794: 5674: 5633: 5618: 5603: 5595: 5546: 5448: 5418: 5086: 4996: 4736: 4689: 4634: 4517: 4483: 1808: 1781: 1715: 1698:

side of the channels while saxitoxin, neosaxitoxin and tetrodotoxin bind to the

1627: 1617: 1595: 1590: 1541: 1442: 1438: 1424: 1402: 1154: 1026: 1018: 1014: 987: 861: 849: 837: 697: 469: 214: 209: 204: 108: 4253:

López-Valverde A, de Vicente J, Martínez-Domínguez L, de Diego RG (July 2014).

4042: 3501: 1943: 1374:

are prone to producing allergic reactions, which may necessitate the use of an

1021:, for example, though it has LA properties). LA drugs act mainly by inhibiting 6461: 6256: 6082: 6030: 5974: 5930: 5902: 5882: 5866: 5862: 5835: 5790: 5679: 5643: 5638: 5623: 5541: 5536: 5511: 5493: 5468: 5463: 5413: 5264: 5235: 5193: 5162: 5157: 5096: 5091: 5081: 5019: 5005: 4945: 4900: 4848: 4768: 4764: 4705: 4665: 4620: 4616: 4506: 4442: 4392: 4357: 4353: 3536: 3040:"Moxidectin toxicosis in a puppy successfully treated with intravenous lipids" 1837: 1832: 1691: 1684: 1632: 1622: 1601: 1562: 1515: 1488: 1463: 1448: 1428: 1420: 1413: 1050: 998: 956: 920: 912: 665: 320: 296: 199: 187: 160: 56: 3428: 3238: 2340: 2304: 2260: 2177: 2160: 1951: 1874: 1240:

Before injection, disinfect gingival sulcus with 0.2% chlorhexidine solution.

978:. One published case has been reported of successful treatment of refractory 6018: 6014: 5996: 5961: 5896: 5817: 5628: 5613: 5590: 5488: 5423: 5172: 5152: 5126: 5101: 5036: 5014: 4842: 4755: 4629: 4271: 4254: 3996:

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics

3628:

Pashley D (October 1986). "Systemic effects of intraligamental injections".

3165: 2738:

Rosenblatt MA, Abel M, Fischer GW, Itzkovich CJ, Eisenkraft JB (July 2006).

2659: 2490: 2236: 1654: 1611: 1585: 1578: 1455: 1434: 1383: 1054: 983: 916: 657: 417: 300: 277: 182: 84: 4280: 4211: 4092: 4050: 4015: 3979: 3943: 3873: 3865: 3544: 3509: 3447: 3361: 3308: 3205: 3166:"BestBets: The Effect of Warming Local anesthetics on Pain of Infiltration" 3063: 3024: 2983: 2926: 2860: 2811: 2765: 2713: 2667: 2498: 2268: 2186: 2134: 2093: 2050: 1289:

ILIs are not recommended for patients with active periodontal inflammation.

4184: 3916: 3835: 3800: 3757: 3749: 3719: 3684: 3649: 3614: 3474: 3396: 3273: 2621: 2221: 1969: 1643: 6406: 6105: 6026: 6010: 5988: 5978: 5839: 5478: 5428: 5273: 5137: 5133: 5106: 4545: 4478: 4397: 3461:

Nazif M (January 1970). "Local anesthesia for patients with hemophilia".

3340:

Meechan JG (November 2002). "Supplementary routes to local anaesthesia".

2125: 2108: 1793: 1789: 1551: 1508: 1492: 1386:) impaired hepatic metabolism is also a consideration when using esters. 904: 795: 704: 438: 399: 259: 165: 3416:

Journal of International Society of Preventive & Community Dentistry

5531: 5516: 5443: 5249: 5167: 4832: 4599: 4421: 4371: 3852:

Meechan JG (January 1999). "How to overcome failed local anaesthesia".

1785: 1740: in this section. Unsourced material may be challenged and removed. 1679: 1674: 1669: 1525: 1445:(recommended final concentrations of 0.5, 0.25, and 0.5%, respectively) 1318: 889: 881: 731:

Symptoms may continue to improve for up to 18 months following injury.

708: 646: 143: 119: 3971: 2042: 1574: 1408:

LA solutions for injection are sometimes mixed with vasoconstrictors (

6002: 5823: 4931: 4594: 2323:

Successful local anesthesia for restorative dentistry and endodontics

1030: 1022: 572: 374: 349: 1504: 1149:, usually at the lumbar spine (in the lower back), where it acts on 755:

or intrasupport tissue administration are accidentally delivered as

606:, peripheral nerve blocks, spinal anesthesia or epidural anesthesia 5782: 3039: 794:

Initial symptoms of systemic toxicity include ringing in the ears (

494:

infiltration anesthesia, field blocks, or peripheral nerve blocks,

67:) in a specific body part without loss of consciousness, providing 5582: 5395: 5231: 4941: 4436: 1642: 1573: 1503: 1491:. The commonly held belief that LA with vasoconstrictor can cause 1375: 1317: 748: 638: 378: 60: 38: 3086:

Goodman & Gilman's: The Pharmacological Basis of Therapeutics

2235:

Flaherty, James; Horn, Jean-Louis; Derby, Ryan (September 2014).

4935: 1777: 1769: 1694:, and have the suffix -toxin in their names. Cocaine binds the 993:

The design of a 'homemade' lipid rescue kit has been described.

810: 243: 64: 6055: 5731: 5348: 4312: 3488:

Moore PA, Haas DA (October 2010). "Paresthesias in dentistry".

1330:

Local anesthetic solutions for injection typically consist of:

645:. It may also be suitable for other kinds of punctures such as 306:

Some typical uses of conduction anesthesia for acute pain are:

75:, which eliminates all sensation in the entire body and causes 6755:

American Society of Anesthesia Technologists & Technicians

1709: 580: 576: 2581:

Univ. of Wisconsin, Local Anesthesia and Regional Anesthetics

1487:

Using LA with vasoconstrictor is safe in regions supplied by

1337:

A vehicle, which is usually water-based or just sterile water

3252:

Meechan JG (December 1992). "Intraligamentary anaesthesia".

2109:"General anaesthesia vs local anaesthesia: an ongoing story" 146:", because cocaine was formerly used as a local anesthetic. 633:(EMLA) is most commonly used to enable relatively painless 6719:

Helsinki Declaration for Patient Safety in Anaesthesiology

6566:

Effects of early-life exposures to anesthesia on the brain

1187:

alveolar, incisive, mental, lingual and mylohyoid nerves.

1127:

Plexus anesthesia is injection of LA in the vicinity of a

936:

the behavioral effects of lidocaine on offspring in rats.

6770:

Association of Anaesthetists of Great Britain and Ireland

2881:

Association of Anaesthetists of Great Britain and Ireland

976:

Association of Anaesthetists of Great Britain and Ireland

4296: 3140:

The Journal of the American Society of Anesthesiologists

3410:

Shastry SP, Kaul R, Baroudi K, Umar D (December 2014).

1807:

Intravenous regional anesthesia was first described by

482:

during cataract removal or other ophthalmic procedures

6800:

European Society of Anaesthesiology and Intensive Care

4198:

Nielsen LJ, Lumholt P, Hölmich LR (October 2014). "".

1926:

Greenbaum, R. A.; Kaye, G.; Mason, P. D. (July 1987).

5827: 4341:

Anatomical Therapeutic Chemical Classification System

2372:"Nerve damage associated with peripheral nerve block" 728:

in some degree of permanent persistent nerve damage.

527:

epidural anesthesia combined with general anesthesia

511:

plexus anesthesia or intravenous regional anesthesia

3412:"Hemophilia A: Dental considerations and management" 1454:

Septocaine (trade name Septodont), a combination of

668:(visualization of the inner surface of the bladder) 6785:

Australian and New Zealand College of Anaesthetists

6742: 6706: 6655: 6609: 6543: 6475: 6394: 6358: 6305: 6244: 6093: 5939: 5849: 5787:

Tooltip Serotonin–norepinephrine reuptake inhibitor

5772: 5652: 5581: 5555: 5502: 5404: 5394: 5258: 5230: 5186: 4995: 4930: 4893: 4841: 4754: 4698: 4658: 4615: 4499: 4435: 4347: 4129: 2556:Facial plastic, reconstructive, and trauma surgery 2321:Reader A, Nusstein J, Drum M (12 September 2014). 2072:"Current world literature. Drugs in anaesthesia". 5908: 5801: 4066: 4064: 4062: 4060: 3044:Journal of Veterinary Emergency and Critical Care 2875:"Management of severe local anaesthetic toxicity" 2733: 2731: 2549: 2547: 2453:Meyler's Side Effects of Drugs Used in Anesthesia 1989:(3 ed.). New York, NY: McGraw-Hill Education 1349:(antioxidant), e.g. if epinephrine is used, then 1041:This is referred to as state-dependent blockade. 4136:. New York: McGraw-Hill, Medical Pub. Division. 4132:Pharmacology: PreTest self-assessment and review 3113:. In Santos AC, Epstein JN, Chaudhuri K (eds.). 3075: 3073: 2641: 2639: 2589: 2587: 1065:Sensitivity of nerve fibers to local anesthetics 246:or other solvents/carriers for deeper absorption 3816:Oral Surgery, Oral Medicine, and Oral Pathology 3566:Nelson PW (November 1981). "Injection system". 3223:(6th ed.). St. Louis, Missouri: Elsevier. 2316: 2314: 1134:Epidural anesthesia is an LA injected into the 911:. Exposure to aniline group chemicals such as 87:(loss of muscle function) also can be induced. 3568:The Journal of the American Dental Association 3111:"Drugs commonly used in obstetric anesthesia." 2522:"Intralipid Treatment Of Bupicavaine Toxicity" 6067: 6038: 5743: 5360: 4324: 4223: 4221: 4159:"Vasoconstrictor agents for local anesthesia" 2997:Harvey M, Cave G, Hoggett K (February 2009). 2687: 2685: 2577: 2575: 2159:Torpy JM, Lynm C, Golub RM (September 2011). 1145:Spinal anesthesia is an LA injected into the 8: 6447:Intraoperative neurophysiological monitoring 4339:Major chemical drug groups – based upon the 1776:are believed to have used the leaves of the 1396:(EMLA, eutectic mixture of local anesthetic) 177:Medium Duration of Action and Medium Potency 4297:The American Society of Regional Anesthesia 4230:"Cocaine's use: From the Incas to the U.S." 2785: 2783: 2366: 2364: 2154: 2152: 2150: 2148: 2146: 2144: 6750:American Association of Nurse Anesthetists 6074: 6060: 6052: 5750: 5736: 5728: 5401: 5367: 5353: 5345: 4331: 4317: 4309: 3700:Journal of the American Dental Association 3665:Journal of the American Dental Association 3377:Journal of the American Dental Association 3324:"Intraligamentary Injections in Dentistry" 3289:Journal of the American Dental Association 2381:. Section 12. January 2006. Archived from 2353:: CS1 maint: location missing publisher ( 2280: 2278: 2237:"Regional anesthesia for vascular surgery" 1484:per mille) adrenaline, 4 or 10% cocaine). 6795:International Anesthesia Research Society 6402:ASA physical status classification system 4270: 4174: 3437: 3427: 3329:. Dental Academy of Continuing Education. 3014: 2850: 2755: 2611: 2176: 2124: 1959: 1756:Learn how and when to remove this message 1451:, consisting of lidocaine and epinephrine 656:Surface anesthesia also facilitates some 559:spinal anesthesia or epidural anesthesia 6147:Combined spinal and epidural anaesthesia 2287:Manual of local anaesthesia in dentistry 2107:Bodenham AR, Howell SJ (December 2009). 1932:Journal of the Royal Society of Medicine 1869: 1867: 1210:Contraindication for systemic anesthesia 664:(visualization of the lower airways) or 405: 308: 155:Short Duration of Action and Low Potency 6780:Association of Veterinary Anaesthetists 4303:Regional Anesthesia & Pain Medicine 3038:Crandell DE, Weinberg GL (April 2009). 1863: 1085:(pain sensation), and small myelinated 464:and various other podiatric procedures 228:They are used in various techniques of 5318:Pharmacological classification systems 4685:Selective estrogen receptor modulators 3463:ASDC Journal of Dentistry for Children 3084:. In Brunton LL, Knollmann BC (eds.). 2941:"lipidrescue - Sample LipidRescue Kit" 2346: 2010: 2000: 1322:This LA system is designed to prevent 715:thus increasing the risk of overdose. 6760:American Society of Anesthesiologists 5832:Tooltip monoamine reuptake inhibitors 4965:Non-steroidal anti-inflammatory drugs 3847: 3845: 3731: 3729: 3595:International Journal of Oral Surgery 2648:Regional Anesthesia and Pain Medicine 2520:Stiles P, Prielipp RC (Spring 2009). 2479:Regional Anesthesia and Pain Medicine 2445: 2443: 2441: 2439: 2437: 2435: 2433: 2405: 2403: 2379:Risks Associated with Your Anesthetic 2161:"JAMA patient page. Local anesthesia" 944:Treatment of overdose: "Lipid rescue" 7: 6765:Anaesthesia Trauma and Critical Care 2526:Anesthesia Patient Safety Foundation 1738:adding citations to reliable sources 1213:Presence of systemic health problems 1178:Dental-specific techniques include: 442:(surgery of feet, ankles, and legs) 27:Medications to reversibly block pain 6790:Australian Society of Anaesthetists 6698:Physicians' assistant (anaesthesia) 6601:Postoperative residual curarization 4578:Angiotensin II receptor antagonists 3781:The Journal of Prosthetic Dentistry 2833:Cave G, Harvey M (September 2009). 1389:Sometimes, LAs are combined, e.g.: 629:Topical anesthesia, in the form of 30:For the novel by Günter Grass, see 6678:Operating department practitioners 4085:10.1111/j.1747-4477.1998.tb00251.x 3186:British Journal of Plastic Surgery 2951:from the original on 25 July 2022. 2410:Baart JA, Brand HS (7 June 2017). 970:, have also been shown effective. 25: 6688:Certified anesthesia technologist 6596:Postoperative nausea and vomiting 6111:Procedural sedation and analgesia 5913:Tooltip Tricyclic antidepressants 5806:Tooltip Tricyclic antidepressants 2976:10.1016/j.annemergmed.2006.07.016 2919:10.1016/j.annemergmed.2007.06.004 2074:Current Opinion in Anesthesiology 1334:The local anesthetic agent itself 1138:, where it acts primarily on the 6822: 6813: 6812: 6229:Transverse abdominis plane block 5327: 5307: 5306: 3960:International Endodontic Journal 3354:10.1046/j.1365-2591.2002.00592.x 3342:International Endodontic Journal 3152:10.1097/00000542-200112000-00003 3056:10.1111/j.1476-4431.2009.00402.x 3016:10.1111/j.1553-2712.2008.00313.x 2852:10.1111/j.1553-2712.2009.00499.x 2804:10.1111/j.1365-2044.2006.04740.x 2757:10.1097/00000542-200607000-00033 2706:10.1111/j.1365-2044.2005.04494.x 2613:10.1097/00000542-199804000-00028 2086:10.1097/00001503-200308000-00010 1714: 6823: 6729:History of neuraxial anesthesia 6683:Certified anesthesia technician 6505:Double-lumen endobronchial tube 6366:Blood–gas partition coefficient 6199:Intravenous regional anesthesia 4715:Hypothalamic–pituitary hormones 3712:10.14219/jada.archive.1983.0357 3677:10.14219/jada.archive.1981.0307 3580:10.14219/jada.archive.1981.0380 3490:Dental Clinics of North America 3389:10.14219/jada.archive.1987.0080 3301:10.14219/jada.archive.2003.0262 3080:Catterall WA, Mackie K (2023). 2289:. : Jaypee Brothers Medical P. 1725:needs additional citations for 1161:Intravenous regional anesthesia 1025:influx through sodium-specific 990:overdose using lipid emulsion. 356:intravenous regional anesthesia 6775:Royal College of Anaesthetists 6734:History of tracheal intubation 6381:Minimum alveolar concentration 6318:Anesthesia provision in the US 3088:(14th ed.). McGraw Hill. 2413:Local Anaesthesia in Dentistry 2113:British Journal of Anaesthesia 1399:Lidocaine/tetracaine (Rapydan) 1273:Standard syringes can be used. 769:parasympathetic nervous system 194:High Duration and High Potency 1: 6724:History of general anesthesia 6236:Total intravenous anaesthesia 6184:Inferior alveolar nerve block 6130:Continuous wound infiltration 5569:3-(p-Fluorobenzoyloxy)tropane 5556:ArCO2- (not para-amino or Ph) 4467:Thrombolytics / fibrinolytics 4073:Australian Endodontic Journal 4008:10.1016/j.tripleo.2004.11.009 3909:10.1016/S0099-2399(82)80312-9 3642:10.1016/s0099-2399(86)80206-0 3607:10.1016/s0300-9785(84)80022-8 3198:10.1016/S0007-1226(03)00180-2 2450:Aronson JK (7 October 2008). 2214:10.1016/S0749-8063(05)80425-6 1195:Intraligamentary Infiltration 1104:Clinical techniques include: 1077:In general, autonomic fibers 641:collection) and placement of 6287:Neuromuscular-blocking drugs 5178:Wakefulness-promoting agents 4228:Gazourian A (4 April 1985). 3828:10.1016/0030-4220(82)90273-0 3793:10.1016/0022-3913(83)90273-1 3525:Clinical Oral Investigations 3266:10.1016/0300-5712(92)90018-8 3221:Handbook of local anesthesia 3109:Piehl E, Bucklin BA (2015). 2964:Annals of Emergency Medicine 2907:Annals of Emergency Medicine 2253:10.1016/j.anclin.2014.05.002 81:local anesthetic nerve block 6622:Critical emergency medicine 3003:Academic Emergency Medicine 2945:lipidrescue.squarespace.com 2839:Academic Emergency Medicine 2554:Dolan R (17 October 2003). 2080:(4): 429–436. August 2003. 1353:is used as a reducing agent 1111:Infiltration anesthesia is 595:peripheral vascular surgery 431:intraligamentary anesthesia 59:that causes absence of all 6870: 6668:Anesthesiologist assistant 6530:Relative analgesia machine 5660:Anesthetic/vasoconstrictor 4828:Intravenous immunoglobulin 4043:10.1902/jop.2000.71.9.1453 3932:Quintessence International 3502:10.1016/j.cden.2010.06.016 1944:10.1177/014107688708000708 1182:Vazirani–Akinosi technique 707:and could result in pain, 276:Diagnostic purposes (e.g. 29: 6808: 6576:Local anesthetic toxicity 5985:NMDA receptor antagonists 5688: 5565:(3,4,5-Trimethoxybenzoyl) 5302: 4031:Journal of Periodontology 3537:10.1007/s00784-013-1113-1 3322:Boynes SG (1 June 2018). 1853:List of local anesthetics 1848:List of cocaine analogues 1702:side of sodium channels. 931:Second-generation effects 354:Peripheral nerve blocks, 32:Local Anaesthetic (novel) 6591:Postanesthetic shivering 6457:Neuromuscular monitoring 6348:Rapid sequence induction 6277:Inhalational anesthetics 4883:Topoisomerase inhibitors 4567:renin–angiotensin system 4561:Calcium channel blockers 3429:10.4103/2231-0762.149022 2178:10.1001/jama.306.12.1395 474:surface anesthesia with 286:agents (e.g. lidocaine). 6642:Oral sedation dentistry 6632:Intensive care medicine 6586:Perioperative mortality 6442:Guedel's classification 6189:Intercostal nerve block 5619:Cinchocaine (Dibucaine) 5381:sodium channel blockers 4272:10.1038/sj.bdj.2014.546 2970:(2): 178–85, 185.e1–4. 2660:10.1053/rapm.2003.50041 2491:10.1053/rapm.2002.37127 1233:Technique description: 1204:Single-tooth anesthesia 537:epidural anesthesia or 427:infiltration anesthesia 412:Purposes or procedures 342:Peripheral nerve blocks 139:(with few exceptions). 6693:Anaesthetic technician 6581:Malignant hyperthermia 4675:Hormonal contraception 4605:Bile acid sequestrants 4386:Proton-pump inhibitors 4349:gastrointestinal tract 4259:British Dental Journal 3897:Journal of Endodontics 3866:10.1038/sj.bdj.4800006 3854:British Dental Journal 3630:Journal of Endodontics 3422:(Suppl 3): S147–S152. 2241:Anesthesiology Clinics 2031:ANZ Journal of Surgery 1875:"Types of Anaesthesia" 1650: 1581: 1511: 1327: 1153:roots and part of the 1122:Peripheral nerve block 949:Lipid emulsion therapy 886:para-aminobenzoic acid 787:Central nervous system 745:central nervous system 735:Potential side effects 677:Localized side effects 425:(surface anesthesia), 358:, epidural anesthesia 344:, epidural anesthesia 44: 6515:Laryngeal mask airway 6359:Scientific principles 6328:Dogliotti's principle 6204:Occipital nerve block 6169:Brachial plexus block 5665:Bupivacaine/meloxicam 3750:10.1007/s002469900103 1646: 1577: 1507: 1321: 1081:, small unmyelinated 828:Cardiovascular system 547:Gynecological surgery 488:Head and neck surgery 330:Pudendal nerve blocks 299:can be managed using 255:Brachial plexus block 42: 6561:Drug-induced amnesia 6556:Anesthesia awareness 6490:Anesthetic vaporizer 6467:Thyromental distance 6371:Concentration effect 6245:Pharmacologic agents 6214:Pudendal nerve block 5851:Ion channel blockers 5670:Lidocaine/prilocaine 5479:Procaine (Novocaine) 5284:Radiopharmaceuticals 5072:Antiparkinson agents 4200:Ugeskrift for Laeger 4107:"Allergic Reactions" 3738:Pediatric Cardiology 3254:Journal of Dentistry 3115:Obstetric Anesthesia 2913:(4): 412–5, 415.e1. 1734:improve this article 1394:Lidocaine/prilocaine 1380:pseudocholinesterase 1351:sodium metabisulfite 1343:possibly (see below) 643:intravenous cannulae 631:lidocaine/prilocaine 446:cutaneous anesthesia 315:Possible treatments 268:(subarachnoid block) 239:(surface anesthesia) 95:LAs are of 2 types: 6485:Anaesthetic machine 6343:Tracheal intubation 6333:Intravenous therapy 6272:General anesthetics 6224:Sciatic nerve block 6179:Femoral nerve block 6174:Fascia iliaca block 6152:Epidural anesthesia 6118:Twilight anesthesia 5067:Antimigraine agents 5057:Antidementia agents 4960:Anti-inflammatories 4650:Medicated dressings 4590:Antihyperlipidemics 4417:Diabetes medication 4163:Anesthesia Progress 4157:Yagiela JA (1995). 3219:Malamed SF (2013). 3082:"Local Anesthetics" 2879:anaesthetists.org. 1901:"Local anaesthesia" 1297:Gow-Gates Technique 1207:Low anesthetic dose 1147:cerebrospinal fluid 1005:Mechanism of action 876:Immunologic allergy 822:cerebrospinal fluid 763:Emotional reactions 660:procedures such as 476:topical anesthetics 326:Epidural anesthesia 6571:Emergence delirium 6551:Allergic reactions 6427:Entropy monitoring 6209:Paracervical block 6194:Interpleural block 6157:Spinal anaesthesia 6142:Neuraxial blockade 5715:Never to phase III 4920:Immunosuppressants 4790:Antimycobacterials 4746:Antithyroid agents 4730:Mineralocorticoids 4534:Cardiac stimulants 4524:Cardiac glycosides 4516:cardiac therapy / 4412:Anti-obesity drugs 4109:. Cleveland Clinic 2285:Chitre AP (2016). 2126:10.1093/bja/aep310 1843:General anesthetic 1651: 1582: 1512: 1423:hydrochloride and 1328: 1324:needlestick injury 844:conduction delay, 815:respiratory arrest 804:grand mal seizures 600:topical anesthesia 555:Urological surgery 423:topical anesthesia 396:general anesthesia 337:Postoperative pain 237:Topical anesthesia 73:general anesthetic 71:, as opposed to a 45: 18:Anesthetics, local 6854:Local anesthetics 6836: 6835: 6673:Nurse anesthetist 6500:Bronchial blocker 6495:Arterial catheter 6386:Second gas effect 6313:Airway management 6282:Local anesthetics 6219:Retrobulbar block 6049: 6048: 5957:Botulinum toxin A 5947:Alpha lipoic acid 5893:Local anesthetics 5766:pharmacotherapies 5725: 5724: 5577: 5576: 5376:Local anesthetics 5342: 5341: 5245:Ophthalmologicals 4955:Anabolic steroids 4858:Anticancer agents 4821:Ectoparasiticides 4541:Antihypertensives 4489:Antifibrinolytics 4143:978-0-07-136704-2 3972:10.1111/iej.12773 3124:978-0-07-178613-3 3095:978-1-264-25807-9 2565:978-0-8247-4595-0 2558:. Marcel Dekker. 2388:on 9 October 2007 2043:10.1111/ans.14920 1986:Local Anesthetics 1907:. 19 October 2017 1881:. 17 October 2017 1766: 1765: 1758: 1639:Naturally derived 1470:(0.05%, 500 925:methemoglobinemia 901:Methemoglobinemia 896:Methemoglobinemia 741:peripheral nerves 610: 609: 551:Obstetric surgery 539:spinal anesthesia 533:Abdominal surgery 522:Pulmonary surgery 496:plexus anesthesia 491:(ENT operations) 480:retrobulbar block 362: 361: 266:Spinal anesthesia 132:and do not cause 16:(Redirected from 6861: 6826: 6825: 6816: 6815: 6663:Anesthesiologist 6452:Mallampati score 6412:Bispectral index 6252:Anticholinergics 6076: 6069: 6062: 6053: 6040: 6037:Sodium oxybate ( 5993:dextromethorphan 5914: 5910: 5833: 5829: 5807: 5803: 5788: 5784: 5759:Neuropathic pain 5752: 5745: 5738: 5729: 5402: 5384: 5369: 5362: 5355: 5346: 5331: 5310: 5309: 5294:Senotherapeutics 5148:Neuroprotectives 5143:Mood stabilizers 5042:Anti-ADHD agents 4982:Muscle relaxants 4915:Immunostimulants 4910:Immunomodulators 4742:Thyroid hormones 4680:Fertility agents 4583:Renin inhibitors 4474:Antihemorrhagics 4441:forming organs ( 4427:Dietary minerals 4333: 4326: 4319: 4310: 4285: 4284: 4274: 4250: 4244: 4243: 4241: 4239: 4225: 4216: 4215: 4195: 4189: 4188: 4178: 4169:(3–4): 116–120. 4154: 4148: 4147: 4135: 4128:Stern A (2002). 4125: 4119: 4118: 4116: 4114: 4103: 4097: 4096: 4068: 4055: 4054: 4037:(9): 1453–1459. 4026: 4020: 4019: 3990: 3984: 3983: 3954: 3948: 3947: 3927: 3921: 3920: 3892: 3886: 3885: 3849: 3840: 3839: 3811: 3805: 3804: 3776: 3770: 3769: 3733: 3724: 3723: 3695: 3689: 3688: 3660: 3654: 3653: 3625: 3619: 3618: 3590: 3584: 3583: 3563: 3557: 3556: 3520: 3514: 3513: 3485: 3479: 3478: 3458: 3452: 3451: 3441: 3431: 3407: 3401: 3400: 3372: 3366: 3365: 3337: 3331: 3330: 3328: 3319: 3313: 3312: 3284: 3278: 3277: 3249: 3243: 3242: 3216: 3210: 3209: 3180: 3174: 3173: 3162: 3156: 3155: 3135: 3129: 3128: 3106: 3100: 3099: 3077: 3068: 3067: 3035: 3029: 3028: 3018: 2994: 2988: 2987: 2959: 2953: 2952: 2937: 2931: 2930: 2901: 2895: 2894: 2892: 2890: 2871: 2865: 2864: 2854: 2830: 2824: 2823: 2787: 2778: 2777: 2759: 2735: 2726: 2725: 2689: 2680: 2679: 2643: 2634: 2633: 2615: 2606:(4): 1071–1075. 2591: 2582: 2579: 2570: 2569: 2551: 2542: 2541: 2539: 2537: 2517: 2511: 2510: 2474: 2468: 2467: 2447: 2428: 2427: 2407: 2398: 2397: 2395: 2393: 2387: 2376: 2368: 2359: 2358: 2352: 2344: 2318: 2309: 2308: 2282: 2273: 2272: 2232: 2226: 2225: 2197: 2191: 2190: 2180: 2156: 2139: 2138: 2128: 2104: 2098: 2097: 2069: 2063: 2062: 2037:(7–8): 827–832. 2025: 2019: 2018: 2012: 2008: 2006: 1998: 1996: 1994: 1980: 1974: 1973: 1963: 1923: 1917: 1916: 1914: 1912: 1897: 1891: 1890: 1888: 1886: 1871: 1761: 1754: 1750: 1747: 1741: 1718: 1710: 1483: 1482: 1478: 1410:combination drug 1285:Things to note: 1072:nodes of Ranvier 1038:action potential 907:and symptoms of 842:atrioventricular 777:hyperventilation 613:Diagnostic tests 503:Shoulder surgery 462:hammertoe repair 409:Type of surgery 406: 309: 230:local anesthesia 137:vasoconstriction 69:local anesthesia 49:local anesthetic 21: 6869: 6868: 6864: 6863: 6862: 6860: 6859: 6858: 6839: 6838: 6837: 6832: 6804: 6738: 6702: 6651: 6605: 6539: 6471: 6417:Body mass index 6390: 6354: 6301: 6267:Benzodiazepines 6240: 6089: 6080: 6050: 6045: 5935: 5912: 5859:Anticonvulsants 5845: 5831: 5805: 5786: 5768: 5756: 5726: 5721: 5720: 5705:Clinical trials 5684: 5648: 5600:Levobupivacaine 5573: 5551: 5522:Cyclomethycaine 5498: 5459:Metabutoxycaine 5454:Metabutethamine 5390: 5378: 5373: 5343: 5338: 5334:Medicine portal 5298: 5254: 5226: 5221: 5213:Cough medicines 5208:Bronchodilators 5189: 5182: 5062:Antidepressants 5052:Anticonvulsants 5000: 4991: 4987:Bisphosphonates 4977:Corticosteroids 4939: 4926: 4898: 4889: 4873:Spindle poisons 4863:Antimetabolites 4846: 4837: 4759: 4750: 4725:Glucocorticoids 4720:Corticosteroids 4701: 4694: 4661: 4654: 4611: 4529:Antiarrhythmics 4502: 4495: 4452:Antithrombotics 4440: 4431: 4407:Antipropulsives 4403:Antidiarrhoeals 4380: 4351: 4343: 4337: 4293: 4288: 4252: 4251: 4247: 4237: 4235: 4233:Boca Raton News 4227: 4226: 4219: 4197: 4196: 4192: 4156: 4155: 4151: 4144: 4127: 4126: 4122: 4112: 4110: 4105: 4104: 4100: 4070: 4069: 4058: 4028: 4027: 4023: 3992: 3991: 3987: 3956: 3955: 3951: 3929: 3928: 3924: 3894: 3893: 3889: 3851: 3850: 3843: 3813: 3812: 3808: 3778: 3777: 3773: 3735: 3734: 3727: 3697: 3696: 3692: 3662: 3661: 3657: 3636:(10): 501–504. 3627: 3626: 3622: 3592: 3591: 3587: 3565: 3564: 3560: 3522: 3521: 3517: 3487: 3486: 3482: 3460: 3459: 3455: 3409: 3408: 3404: 3374: 3373: 3369: 3348:(11): 885–896. 3339: 3338: 3334: 3326: 3321: 3320: 3316: 3286: 3285: 3281: 3251: 3250: 3246: 3231: 3218: 3217: 3213: 3182: 3181: 3177: 3164: 3163: 3159: 3137: 3136: 3132: 3125: 3117:. 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surgery) 517:Cardiac surgery 505: 490: 441: 391: 383:anticonvulsants 367: 293: 284:Anti-arrhythmic 223: 152: 130:abuse potential 93: 77:unconsciousness 35: 28: 23: 22: 15: 12: 11: 5: 6867: 6865: 6857: 6856: 6851: 6841: 6840: 6834: 6833: 6831: 6830: 6820: 6809: 6806: 6805: 6803: 6802: 6797: 6792: 6787: 6782: 6777: 6772: 6767: 6762: 6757: 6752: 6746: 6744: 6740: 6739: 6737: 6736: 6731: 6726: 6721: 6716: 6710: 6708: 6704: 6703: 6701: 6700: 6695: 6690: 6685: 6680: 6675: 6670: 6665: 6659: 6657: 6653: 6652: 6650: 6649: 6644: 6639: 6634: 6629: 6624: 6619: 6617:Cardiothoracic 6613: 6611: 6610:Subspecialties 6607: 6606: 6604: 6603: 6598: 6593: 6588: 6583: 6578: 6573: 6568: 6563: 6558: 6553: 6547: 6545: 6541: 6540: 6538: 6537: 6532: 6527: 6525:Magill forceps 6522: 6520:Laryngeal tube 6517: 6512: 6507: 6502: 6497: 6492: 6487: 6481: 6479: 6473: 6472: 6470: 6469: 6464: 6459: 6454: 6449: 6444: 6439: 6434: 6432:Fick principle 6429: 6424: 6419: 6414: 6409: 6404: 6398: 6396: 6392: 6391: 6389: 6388: 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4291:External links 4289: 4287: 4286: 4245: 4217: 4190: 4149: 4142: 4120: 4098: 4056: 4021: 4002:(3): 361–366. 3985: 3949: 3938:(6): 469–476. 3922: 3887: 3841: 3822:(2): 117–121. 3806: 3787:(3): 337–339. 3771: 3725: 3706:(6): 953–956. 3690: 3671:(4): 571–575. 3655: 3620: 3585: 3558: 3531:(2): 351–358. 3515: 3496:(4): 715–730. 3480: 3453: 3402: 3383:(3): 341–344. 3367: 3332: 3314: 3295:(6): 753–760. 3279: 3260:(6): 325–332. 3244: 3229: 3211: 3192:(5): 478–483. 3175: 3157: 3130: 3123: 3101: 3094: 3069: 3050:(2): 181–186. 3030: 3009:(2): 151–156. 2989: 2954: 2932: 2896: 2866: 2845:(9): 815–824. 2825: 2798:(8): 800–801. 2779: 2750:(1): 217–218. 2744:Anesthesiology 2727: 2700:(2): 107–109. 2681: 2654:(3): 198–202. 2635: 2600:Anesthesiology 2583: 2571: 2564: 2543: 2512: 2485:(6): 556–561. 2469: 2462: 2429: 2422: 2399: 2360: 2331: 2310: 2296:978-9352501984 2295: 2274: 2247:(3): 639–659. 2227: 2208:(3): 295–300. 2192: 2140: 2119:(6): 785–789. 2099: 2064: 2020: 1975: 1938:(7): 418–421. 1918: 1892: 1862: 1860: 1857: 1856: 1855: 1850: 1845: 1840: 1835: 1828: 1825: 1772:, the ancient 1764: 1763: 1722: 1720: 1713: 1707: 1704: 1688: 1687: 1682: 1677: 1672: 1667: 1662: 1657: 1640: 1637: 1636: 1635: 1630: 1625: 1620: 1615: 1609: 1604: 1599: 1593: 1588: 1571: 1568: 1567: 1566: 1560: 1555: 1549: 1544: 1539: 1533: 1528: 1523: 1521:Chloroprocaine 1518: 1501: 1498: 1467: 1460: 1459: 1452: 1446: 1432: 1406: 1405: 1400: 1397: 1369: 1368: 1363: 1354: 1347:Reducing agent 1344: 1338: 1335: 1315: 1312: 1298: 1295: 1294: 1293: 1290: 1283: 1282: 1278: 1274: 1267: 1266: 1263: 1260: 1257: 1254: 1251: 1247: 1244: 1241: 1238: 1215: 1214: 1211: 1208: 1205: 1200:purposed for: 1196: 1193: 1183: 1180: 1176: 1175: 1168: 1167: 1164: 1158: 1143: 1136:epidural space 1132: 1125: 1119: 1116: 1109: 1094: 1091: 1066: 1063: 1006: 1003: 980:cardiac arrest 945: 942: 932: 929: 897: 894: 877: 874: 869: 866: 829: 826: 788: 785: 764: 761: 736: 733: 724: 721: 693: 690: 678: 675: 673: 670: 623: 620: 614: 611: 608: 607: 597: 587: 586: 583: 561: 560: 557: 543: 542: 535: 529: 528: 525: 513: 512: 509: 499: 498: 492: 484: 483: 472: 466: 465: 450:nail avulsions 443: 435: 434: 420: 414: 413: 410: 390: 387: 366: 363: 360: 359: 352: 346: 345: 339: 333: 332: 323: 317: 316: 313: 292: 289: 288: 287: 281: 274: 269: 263: 260:Epidural block 257: 252: 247: 240: 222: 219: 218: 217: 212: 207: 202: 191: 190: 185: 174: 173: 171:Chloroprocaine 168: 163: 151: 148: 126: 125: 124: 123: 116:Synthetic LAs 114: 113: 112: 106: 99:Clinical LAs: 92: 91:Classification 89: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 6866: 6855: 6852: 6850: 6847: 6846: 6844: 6829: 6821: 6819: 6811: 6810: 6807: 6801: 6798: 6796: 6793: 6791: 6788: 6786: 6783: 6781: 6778: 6776: 6773: 6771: 6768: 6766: 6763: 6761: 6758: 6756: 6753: 6751: 6748: 6747: 6745: 6743:Organizations 6741: 6735: 6732: 6730: 6727: 6725: 6722: 6720: 6717: 6715: 6712: 6711: 6709: 6705: 6699: 6696: 6694: 6691: 6689: 6686: 6684: 6681: 6679: 6676: 6674: 6671: 6669: 6666: 6664: 6661: 6660: 6658: 6654: 6648: 6647:Pain medicine 6645: 6643: 6640: 6638: 6635: 6633: 6630: 6628: 6625: 6623: 6620: 6618: 6615: 6614: 6612: 6608: 6602: 6599: 6597: 6594: 6592: 6589: 6587: 6584: 6582: 6579: 6577: 6574: 6572: 6569: 6567: 6564: 6562: 6559: 6557: 6554: 6552: 6549: 6548: 6546: 6544:Complications 6542: 6536: 6535:Tracheal tube 6533: 6531: 6528: 6526: 6523: 6521: 6518: 6516: 6513: 6511: 6508: 6506: 6503: 6501: 6498: 6496: 6493: 6491: 6488: 6486: 6483: 6482: 6480: 6478: 6474: 6468: 6465: 6463: 6460: 6458: 6455: 6453: 6450: 6448: 6445: 6443: 6440: 6438: 6437:Goldman index 6435: 6433: 6430: 6428: 6425: 6423: 6420: 6418: 6415: 6413: 6410: 6408: 6405: 6403: 6400: 6399: 6397: 6393: 6387: 6384: 6382: 6379: 6377: 6374: 6372: 6369: 6367: 6364: 6363: 6361: 6357: 6349: 6346: 6345: 6344: 6341: 6339: 6336: 6334: 6331: 6329: 6326: 6324: 6321: 6319: 6316: 6314: 6311: 6310: 6308: 6304: 6298: 6295: 6293: 6290: 6288: 6285: 6283: 6280: 6278: 6275: 6273: 6270: 6268: 6265: 6263: 6260: 6258: 6255: 6253: 6250: 6249: 6247: 6243: 6237: 6234: 6230: 6227: 6225: 6222: 6220: 6217: 6215: 6212: 6210: 6207: 6205: 6202: 6200: 6197: 6195: 6192: 6190: 6187: 6185: 6182: 6180: 6177: 6175: 6172: 6170: 6167: 6166: 6165: 6162: 6158: 6155: 6153: 6150: 6148: 6145: 6144: 6143: 6140: 6136: 6133: 6131: 6128: 6127: 6126: 6123: 6119: 6116: 6112: 6109: 6108: 6107: 6104: 6103: 6102: 6099: 6098: 6096: 6092: 6088: 6084: 6077: 6072: 6070: 6065: 6063: 6058: 6057: 6054: 6042: 6035: 6032: 6028: 6024: 6023:buprenorphine 6020: 6016: 6012: 6008: 6004: 6001: 5998: 5994: 5990: 5986: 5983: 5980: 5976: 5972: 5968: 5965: 5963: 5960: 5958: 5955: 5953: 5950: 5948: 5945: 5944: 5942: 5938: 5932: 5929: 5926: 5922: 5921:nortriptyline 5918: 5917:amitriptyline 5911: 5906: 5904: 5901: 5898: 5894: 5891: 5888: 5884: 5880: 5879:oxcarbazepine 5876: 5875:carbamazepine 5872: 5868: 5864: 5860: 5857: 5856: 5854: 5852: 5848: 5841: 5837: 5830: 5825: 5822: 5819: 5815: 5814:nortriptyline 5811: 5810:amitriptyline 5804: 5799: 5796: 5792: 5785: 5780: 5779: 5777: 5775: 5771: 5767: 5764: 5760: 5753: 5748: 5746: 5741: 5739: 5734: 5733: 5730: 5714: 5712: 5709: 5708: 5706: 5703: 5700: 5697: 5695: 5692: 5691: 5687: 5681: 5678: 5676: 5673: 5671: 5668: 5666: 5663: 5661: 5658: 5657: 5655: 5651: 5645: 5642: 5640: 5637: 5635: 5632: 5630: 5627: 5625: 5622: 5620: 5617: 5615: 5612: 5610: 5609:Butanilicaine 5607: 5605: 5601: 5597: 5594: 5592: 5589: 5588: 5586: 5584: 5580: 5570: 5567: 5564: 5561: 5560: 5558: 5554: 5548: 5545: 5543: 5540: 5538: 5535: 5533: 5530: 5528: 5525: 5523: 5520: 5518: 5515: 5513: 5510: 5509: 5507: 5505: 5501: 5495: 5492: 5490: 5487: 5485: 5482: 5480: 5477: 5475: 5472: 5470: 5467: 5465: 5462: 5460: 5457: 5455: 5452: 5450: 5447: 5445: 5442: 5440: 5437: 5435: 5432: 5430: 5427: 5425: 5422: 5420: 5417: 5415: 5412: 5411: 5409: 5407: 5403: 5400: 5397: 5393: 5388: 5382: 5377: 5370: 5365: 5363: 5358: 5356: 5351: 5350: 5347: 5335: 5330: 5326: 5324: 5321: 5319: 5316: 5314: 5305: 5304: 5301: 5295: 5292: 5290: 5287: 5285: 5282: 5280: 5277: 5275: 5272: 5271: 5269: 5266: 5262: 5257: 5251: 5248: 5246: 5243: 5242: 5240: 5237: 5233: 5229: 5223: 5216: 5214: 5211: 5209: 5206: 5204: 5203:Decongestants 5201: 5200: 5198: 5195: 5191: 5185: 5179: 5176: 5174: 5171: 5169: 5166: 5164: 5161: 5159: 5156: 5154: 5151: 5149: 5146: 5144: 5141: 5139: 5135: 5132: 5128: 5125: 5123: 5122:Dissociatives 5120: 5118: 5115: 5114: 5113: 5112:Hallucinogens 5110: 5108: 5105: 5103: 5100: 5098: 5095: 5093: 5090: 5088: 5085: 5083: 5080: 5078: 5075: 5073: 5070: 5068: 5065: 5063: 5060: 5058: 5055: 5053: 5050: 5048: 5045: 5043: 5040: 5038: 5035: 5031: 5028: 5026: 5023: 5022: 5021: 5018: 5016: 5013: 5012: 5010: 5007: 5003: 4998: 4994: 4988: 4985: 4983: 4980: 4978: 4975: 4973: 4970: 4966: 4963: 4962: 4961: 4958: 4956: 4953: 4952: 4950: 4947: 4943: 4937: 4933: 4929: 4921: 4918: 4916: 4913: 4912: 4911: 4908: 4907: 4905: 4902: 4896: 4892: 4884: 4881: 4879: 4876: 4874: 4871: 4869: 4866: 4864: 4861: 4860: 4859: 4856: 4855: 4853: 4850: 4844: 4840: 4834: 4831: 4829: 4826: 4822: 4819: 4817: 4816:Anthelmintics 4814: 4812: 4809: 4808: 4807: 4804: 4802: 4799: 4797: 4794: 4791: 4787: 4783: 4780: 4779: 4777: 4774: 4770: 4766: 4762: 4757: 4753: 4747: 4743: 4740: 4738: 4735: 4731: 4728: 4726: 4723: 4722: 4721: 4718: 4716: 4713: 4712: 4710: 4707: 4703: 4697: 4691: 4688: 4686: 4683: 4681: 4678: 4676: 4673: 4672: 4670: 4667: 4663: 4660:genitourinary 4657: 4651: 4648: 4646: 4643: 4641: 4640:Antipruritics 4638: 4636: 4633: 4631: 4628: 4627: 4625: 4622: 4618: 4614: 4606: 4603: 4601: 4598: 4596: 4593: 4592: 4591: 4588: 4584: 4581: 4579: 4576: 4574: 4571: 4570: 4569: 4568: 4564: 4562: 4559: 4557: 4556:Beta blockers 4554: 4552: 4549: 4547: 4544: 4542: 4539: 4535: 4532: 4530: 4527: 4525: 4522: 4521: 4520: 4519: 4514: 4513: 4511: 4508: 4504: 4498: 4490: 4487: 4485: 4482: 4480: 4477: 4476: 4475: 4472: 4468: 4465: 4463: 4460: 4458: 4457:Antiplatelets 4455: 4454: 4453: 4450: 4449: 4447: 4444: 4438: 4434: 4428: 4425: 4423: 4420: 4418: 4415: 4413: 4410: 4408: 4404: 4401: 4399: 4396: 4394: 4391: 4387: 4384: 4382: 4375: 4373: 4370: 4369: 4368: 4365: 4364: 4362: 4359: 4355: 4350: 4346: 4342: 4334: 4329: 4327: 4322: 4320: 4315: 4314: 4311: 4305: 4304: 4300: 4298: 4295: 4294: 4290: 4282: 4278: 4273: 4268: 4264: 4260: 4256: 4249: 4246: 4234: 4231: 4224: 4222: 4218: 4213: 4209: 4205: 4201: 4194: 4191: 4186: 4182: 4177: 4172: 4168: 4164: 4160: 4153: 4150: 4145: 4139: 4134: 4133: 4124: 4121: 4108: 4102: 4099: 4094: 4090: 4086: 4082: 4078: 4074: 4067: 4065: 4063: 4061: 4057: 4052: 4048: 4044: 4040: 4036: 4032: 4025: 4022: 4017: 4013: 4009: 4005: 4001: 3997: 3989: 3986: 3981: 3977: 3973: 3969: 3965: 3961: 3953: 3950: 3945: 3941: 3937: 3933: 3926: 3923: 3918: 3914: 3910: 3906: 3902: 3898: 3891: 3888: 3883: 3879: 3875: 3871: 3867: 3863: 3859: 3855: 3848: 3846: 3842: 3837: 3833: 3829: 3825: 3821: 3817: 3810: 3807: 3802: 3798: 3794: 3790: 3786: 3782: 3775: 3772: 3767: 3763: 3759: 3755: 3751: 3747: 3743: 3739: 3732: 3730: 3726: 3721: 3717: 3713: 3709: 3705: 3701: 3694: 3691: 3686: 3682: 3678: 3674: 3670: 3666: 3659: 3656: 3651: 3647: 3643: 3639: 3635: 3631: 3624: 3621: 3616: 3612: 3608: 3604: 3600: 3596: 3589: 3586: 3581: 3577: 3573: 3569: 3562: 3559: 3554: 3550: 3546: 3542: 3538: 3534: 3530: 3526: 3519: 3516: 3511: 3507: 3503: 3499: 3495: 3491: 3484: 3481: 3476: 3472: 3468: 3464: 3457: 3454: 3449: 3445: 3440: 3435: 3430: 3425: 3421: 3417: 3413: 3406: 3403: 3398: 3394: 3390: 3386: 3382: 3378: 3371: 3368: 3363: 3359: 3355: 3351: 3347: 3343: 3336: 3333: 3325: 3318: 3315: 3310: 3306: 3302: 3298: 3294: 3290: 3283: 3280: 3275: 3271: 3267: 3263: 3259: 3255: 3248: 3245: 3240: 3236: 3232: 3230:9780323074131 3226: 3222: 3215: 3212: 3207: 3203: 3199: 3195: 3191: 3187: 3179: 3176: 3171: 3167: 3161: 3158: 3153: 3149: 3145: 3141: 3134: 3131: 3126: 3120: 3116: 3112: 3105: 3102: 3097: 3091: 3087: 3083: 3076: 3074: 3070: 3065: 3061: 3057: 3053: 3049: 3045: 3041: 3034: 3031: 3026: 3022: 3017: 3012: 3008: 3004: 3000: 2993: 2990: 2985: 2981: 2977: 2973: 2969: 2965: 2958: 2955: 2950: 2946: 2942: 2936: 2933: 2928: 2924: 2920: 2916: 2912: 2908: 2900: 2897: 2884: 2882: 2876: 2870: 2867: 2862: 2858: 2853: 2848: 2844: 2840: 2836: 2829: 2826: 2821: 2817: 2813: 2809: 2805: 2801: 2797: 2793: 2786: 2784: 2780: 2775: 2771: 2767: 2763: 2758: 2753: 2749: 2745: 2741: 2734: 2732: 2728: 2723: 2719: 2715: 2711: 2707: 2703: 2699: 2695: 2688: 2686: 2682: 2677: 2673: 2669: 2665: 2661: 2657: 2653: 2649: 2642: 2640: 2636: 2631: 2627: 2623: 2619: 2614: 2609: 2605: 2601: 2597: 2590: 2588: 2584: 2578: 2576: 2572: 2567: 2561: 2557: 2550: 2548: 2544: 2531: 2527: 2523: 2516: 2513: 2508: 2504: 2500: 2496: 2492: 2488: 2484: 2480: 2473: 2470: 2465: 2463:9780444532701 2459: 2455: 2454: 2446: 2444: 2442: 2440: 2438: 2436: 2434: 2430: 2425: 2423:9783319437057 2419: 2415: 2414: 2406: 2404: 2400: 2384: 2380: 2373: 2367: 2365: 2361: 2356: 2350: 2342: 2338: 2334: 2332:9780867156157 2328: 2324: 2317: 2315: 2311: 2306: 2302: 2298: 2292: 2288: 2281: 2279: 2275: 2270: 2266: 2262: 2258: 2254: 2250: 2246: 2242: 2238: 2231: 2228: 2223: 2219: 2215: 2211: 2207: 2203: 2196: 2193: 2188: 2184: 2179: 2174: 2170: 2166: 2162: 2155: 2153: 2151: 2149: 2147: 2145: 2141: 2136: 2132: 2127: 2122: 2118: 2114: 2110: 2103: 2100: 2095: 2091: 2087: 2083: 2079: 2075: 2068: 2065: 2060: 2056: 2052: 2048: 2044: 2040: 2036: 2032: 2024: 2021: 2016: 2004: 1988: 1987: 1979: 1976: 1971: 1967: 1962: 1957: 1953: 1949: 1945: 1941: 1937: 1933: 1929: 1922: 1919: 1906: 1902: 1896: 1893: 1880: 1876: 1870: 1868: 1864: 1858: 1854: 1851: 1849: 1846: 1844: 1841: 1839: 1836: 1834: 1831: 1830: 1826: 1824: 1821: 1816: 1812: 1810: 1805: 1801: 1797: 1795: 1791: 1787: 1783: 1782:Incas culture 1779: 1775: 1771: 1760: 1757: 1749: 1746:February 2014 1739: 1735: 1729: 1728: 1723:This section 1721: 1717: 1712: 1711: 1705: 1703: 1701: 1700:extracellular 1697: 1696:intracellular 1693: 1686: 1683: 1681: 1678: 1676: 1673: 1671: 1668: 1666: 1663: 1661: 1658: 1656: 1653: 1652: 1649: 1645: 1638: 1634: 1631: 1629: 1626: 1624: 1621: 1619: 1616: 1613: 1610: 1608: 1605: 1603: 1600: 1597: 1594: 1592: 1589: 1587: 1584: 1583: 1580: 1576: 1569: 1565:(Amethocaine) 1564: 1561: 1559: 1556: 1553: 1550: 1548: 1545: 1543: 1540: 1537: 1534: 1532: 1529: 1527: 1524: 1522: 1519: 1517: 1514: 1513: 1510: 1506: 1499: 1497: 1494: 1490: 1485: 1473: 1465: 1457: 1453: 1450: 1447: 1444: 1440: 1436: 1433: 1430: 1426: 1422: 1419: 1418: 1417: 1415: 1411: 1404: 1401: 1398: 1395: 1392: 1391: 1390: 1387: 1385: 1381: 1377: 1373: 1367: 1364: 1362: 1361:methylparaben 1358: 1355: 1352: 1348: 1345: 1342: 1339: 1336: 1333: 1332: 1331: 1325: 1320: 1313: 1311: 1307: 1303: 1296: 1291: 1288: 1287: 1286: 1279: 1275: 1272: 1271: 1270: 1264: 1261: 1258: 1255: 1252: 1248: 1245: 1242: 1239: 1236: 1235: 1234: 1231: 1227: 1223: 1219: 1212: 1209: 1206: 1203: 1202: 1201: 1194: 1192: 1188: 1181: 1179: 1172: 1171: 1170: 1165: 1162: 1159: 1156: 1152: 1148: 1144: 1141: 1137: 1133: 1130: 1126: 1123: 1120: 1117: 1114: 1110: 1107: 1106: 1105: 1102: 1099: 1092: 1090: 1088: 1084: 1080: 1079:Type B fibers 1075: 1073: 1064: 1062: 1058: 1056: 1053:which cannot 1052: 1047: 1044:LAs are weak 1042: 1039: 1035: 1034:cell membrane 1032: 1028: 1024: 1020: 1016: 1012: 1004: 1002: 1000: 994: 991: 989: 985: 981: 977: 971: 969: 965: 960: 958: 954: 950: 943: 941: 937: 930: 928: 926: 922: 918: 914: 910: 906: 902: 895: 893: 891: 887: 883: 875: 873: 867: 865: 863: 859: 855: 851: 847: 843: 839: 834: 827: 825: 823: 818: 816: 812: 807: 805: 799: 797: 792: 786: 784: 780: 778: 773: 770: 762: 760: 758: 757:intravascular 754: 750: 746: 742: 734: 732: 729: 722: 720: 716: 712: 710: 706: 701: 699: 691: 689: 686: 683: 676: 671: 669: 667: 663: 659: 654: 652: 651:amniocentesis 649:drainage and 648: 644: 640: 636: 632: 627: 621: 619: 612: 605: 601: 598: 596: 592: 589: 588: 584: 582: 578: 574: 570: 569:joint surgery 566: 563: 562: 558: 556: 552: 548: 545: 544: 540: 536: 534: 531: 530: 526: 523: 518: 515: 514: 510: 508: 504: 501: 500: 497: 493: 489: 486: 485: 481: 477: 473: 471: 468: 467: 463: 459: 455: 451: 447: 444: 440: 437: 436: 432: 428: 424: 421: 419: 416: 415: 411: 408: 407: 404: 401: 397: 388: 386: 384: 380: 376: 371: 364: 357: 353: 351: 348: 347: 343: 340: 338: 335: 334: 331: 327: 324: 322: 319: 318: 314: 312:Type of pain 311: 310: 307: 304: 302: 298: 290: 285: 282: 279: 275: 273: 272:Iontophoresis 270: 267: 264: 261: 258: 256: 253: 251: 248: 245: 241: 238: 235: 234: 233: 231: 226: 220: 216: 213: 211: 208: 206: 203: 201: 198: 197: 196: 195: 189: 186: 184: 181: 180: 179: 178: 172: 169: 167: 164: 162: 159: 158: 157: 156: 149: 147: 145: 140: 138: 135: 131: 121: 118: 117: 115: 110: 107: 104: 101: 100: 98: 97: 96: 90: 88: 86: 82: 78: 74: 70: 66: 62: 58: 54: 50: 41: 37: 33: 19: 6510:Gas cylinder 6395:Measurements 6338:Laryngoscopy 6323:Bronchoscopy 5967:Cannabinoids 5952:Benfotiamine 5892: 5763:fibromyalgia 5653:Combinations 5474:Propoxycaine 5439:Dimethocaine 5406:Aminobenzoic 5375: 5117:Psychedelics 5087:Aphrodisiacs 5029: 4761:infestations 4737:Sex hormones 4690:Sex hormones 4635:Cicatrizants 4565: 4551:Vasodilators 4518:antianginals 4515: 4367:stomach acid 4366: 4302: 4265:(1): 41–43. 4262: 4258: 4248: 4236:. 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Chicago. 2202:Arthroscopy 2011:|work= 1820:Fidel Pagés 1809:August Bier 1692:neurotoxins 1628:Ropivacaine 1618:Mepivacaine 1598:(Dibucaine) 1596:Cinchocaine 1591:Bupivacaine 1570:Amide group 1554:(Novocaine) 1542:Piperocaine 1538:(Larocaine) 1500:Ester group 1443:epinephrine 1439:bupivacaine 1425:epinephrine 1155:spinal cord 1019:propranolol 1015:nociceptors 1001:toxicosis. 988:lamotrigine 862:ropivacaine 854:arrhythmias 850:bupivacaine 838:hypotension 759:injection. 507:Arm surgery 470:Eye surgery 215:Ropivacaine 210:Cinchocaine 205:Bupivacaine 122:derivatives 109:amino ester 103:amino amide 63:(including 6849:Anesthesia 6843:Categories 6462:Pain scale 6306:Techniques 6083:Anesthesia 6031:tapentadol 5975:dronabinol 5931:Ziconotide 5903:Mexiletine 5883:lacosamide 5867:pregabalin 5863:gabapentin 5836:tapentadol 5791:duloxetine 5680:Iontocaine 5644:Trimecaine 5639:Prilocaine 5624:Etidocaine 5614:Carticaine 5542:Isobucaine 5537:Hexylcaine 5512:Amylocaine 5494:Tetracaine 5469:Orthocaine 5464:Nitracaine 5414:Benzocaine 5173:Stimulants 5153:Nootropics 5127:Deliriants 5102:Entheogens 5037:Anorectics 5015:Analgesics 4868:Alkylating 4801:Antivirals 4756:infections 4630:Emollients 4484:Coagulants 4354:metabolism 4238:2 February 4206:(44): 44. 3574:(5): 692. 2392:10 October 1859:References 1838:Anesthetic 1833:Amylocaine 1778:coca plant 1685:Spilanthol 1633:Trimecaine 1623:Prilocaine 1602:Etidocaine 1563:Tetracaine 1516:Benzocaine 1464:tetracaine 1449:Iontocaine 1429:trade name 1421:Prilocaine 1414:hemorrhage 1269:Syringes: 1093:Techniques 1051:RAC 421-II 999:moxidectin 968:Medialipid 957:Intralipid 921:prilocaine 913:benzocaine 747:, and the 666:cystoscopy 658:endoscopic 622:Other uses 321:Labor pain 301:analgesics 297:acute pain 291:Acute pain 200:Tetracaine 188:Prilocaine 161:Benzocaine 57:medication 6637:Obstetric 6627:Geriatric 6297:Sedatives 6019:methadone 6015:oxycodone 5997:methadone 5962:Bupropion 5897:lidocaine 5818:dosulepin 5711:Phase III 5699:Withdrawn 5629:Lidocaine 5591:Articaine 5563:Amoproxan 5532:β-Eucaine 5527:α-Eucaine 5489:Risocaine 5424:Butacaine 5323:ATC codes 5289:Dressings 5274:Antidotes 5138:Sedatives 5134:Hypnotics 4843:malignant 4700:endocrine 4546:Diuretics 4479:Platelets 4439:and blood 4398:Laxatives 3239:769141511 2349:cite book 2341:892911544 2305:930829770 2261:1932-2275 2013:ignored ( 2003:cite book 1952:0141-0768 1655:Saxitoxin 1612:Lidocaine 1586:Articaine 1579:Lidocaine 1456:articaine 1435:Lidocaine 1384:cirrhosis 1250:apically. 1087:Aδ fibers 984:bupropion 917:lidocaine 882:allergies 868:Endocrine 705:haematoma 418:Dentistry 278:dibucaine 232:such as: 183:Lidocaine 85:paralysis 61:sensation 6818:Category 6407:Baricity 6106:Sedation 6027:tramadol 6011:morphine 5989:ketamine 5979:nabilone 5971:cannabis 5840:tramadol 5429:Butamben 5168:Serenics 4833:Vaccines 4600:Fibrates 4422:Vitamins 4372:Antacids 4281:25012333 4212:25354008 4113:11 April 4093:11431805 4051:11022775 4016:15716846 3980:28370327 3944:16752703 3874:10028738 3545:24077785 3510:20831934 3448:25625071 3362:12453016 3309:12839412 3206:12890461 3064:19691569 3025:19133855 2984:17098328 2949:Archived 2927:17766009 2889:10 April 2861:19845549 2820:43125067 2812:16867094 2774:40214528 2766:16810015 2722:29843241 2714:16430560 2668:12772136 2507:36915462 2499:12430104 2269:25113725 2187:21954483 2135:19918020 2094:17021493 2059:59275648 2051:30684306 1993:10 April 1911:10 April 1885:10 April 1827:See also 1794:procaine 1790:stovaine 1552:Procaine 1509:Procaine 1493:necrosis 1031:neuronal 1011:membrane 905:cyanosis 796:tinnitus 753:epidural 723:Recovery 439:Podiatry 400:sedation 166:Procaine 150:Examples 6828:Outline 6707:History 6292:Opioids 6135:Topical 6101:General 6005:(e.g., 6003:Opioids 5987:(e.g., 5969:(e.g., 5915:(e.g., 5895:(e.g., 5861:(e.g., 5834:(e.g., 5808:(e.g., 5789:(e.g., 5517:Cocaine 5504:Benzoic 5444:Lucaine 5398:by acid 5025:General 4932:muscles 4901:L03–L04 4897:disease 4849:L01–L02 4845:disease 4595:Statins 4185:8934977 4176:2148913 3917:6948904 3882:6618968 3836:6949113 3801:6573480 3766:7178684 3758:8960488 3720:6581222 3685:6945341 3650:3465856 3615:6439659 3553:9525498 3475:4904493 3439:4304051 3397:3470356 3274:1452871 2883:(AAGBI) 2676:6247454 2630:1661916 2622:9579517 2536:12 June 2222:8323615 1970:3309298 1961:1290901 1786:Cocaine 1706:History 1680:Cocaine 1675:Eugenol 1670:Menthol 1526:Cocaine 1479:⁄ 1359:, e.g. 1055:diffuse 1029:in the 964:Liposyn 909:hypoxia 890:paraben 856:. 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