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Advantages/Disadvantages of Regional and
Local Anesthesia.
advantages
patient remains conscious
maintain his own airway
aspiration of gastric contents unlikely
smooth recovery requiring less skilled
nursing care as compared to general anesthesia
advantages
postoperative analgesia
reduction in surgical stress
earlier discharge for outpatients
less expense
Local/Regional Anesthesia
Distance Learning
Course
255 Pages
Est. 26 Hours
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 Disadvantages:
patient may prefer to be asleep
practice and skill is required for the
best results
some blocks require up to 30 minutes or
more to be fully effective
analgesia may not always be totally
effective-patient may require additional analgesics, IV sedation, or
a light general anesthetic
Disadvantages:
toxicity may occur if the local anesthetic
is given intravenously or if an overdose is injected
some operations are unsuitable for local
anesthetics, e.g., thoracotomies
Mechanism of Action of Local Anesthetics
produce a blockade of nerve impulse by preventing
increases in permeability of nerve membranes to Na ions, slowing the rate
of depolarization
interact directly with specific receptors on the sodium
channel, inhibiting sodium influx
do not alter the resting membrane resting potential or
threshold potential
Selection of Local/Regional Anesthetics
specific nerves to be blocked
onset time or latency
required duration of effect
Systemic Toxicity of Local Anesthetics
Drugs-not a great difference in toxicity between equally
potent local anesthetics-one of low toxicity when a large dose is required
Site of injection-vascular sites lead to rapid absorption
accidental I.V. injection is the most common cause of
toxicity
Systemic Toxicity of Local Anesthetics
Addition of Epinephrine-causes local vasoconstriction and
slows absorption
Follow recommended dose
Signs and Symptoms of Local/Regional Anesthesia Toxicity
CNS
CV
Continue
to the PowerPoint Lecture...
From SFC Hill
Joint Special Operations Medical Training Center
In
Operational
Medicine 2001
Bureau of Medicine
and Surgery
Department of the
Navy
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