Cardiovascular and central actions of local anesthetics

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thesis has discussed the common cardiovascular and CNS toxicity problems which may be observed and how to treat them or even better, prevent them in a clinical situation. The importance of lipid solubility of the local anesthesias was discussed in great detail: the bupivacaine had poorer characteristics for use as local anesthesia due to its high lipid protein binding qualities. Reference has been given to animal studies, which are initially useful for giving studies with higher, sometimes lethal, doses which cannot be administered to human volunteers. But also in animals studies, results are variable from one animal to the next. Therefore we can see prevention is our first mode of action to be taken most seriously – for example for using more care in injection administration, to avoid intravenous injection of local anesthesia which has caused as mentioned earlier several dehabilitating effects to animals and to human volunteers. More focus should be taken on prevention of CNS toxicity of local anesthesia, due to the adverse effects also since the cardiac toxicity follows on. In my clinical practice I have observed my supervisors administering local anesthesia more slowly, and even sometimes massaging the point of injection. The slower speed will decrease the chance of toxicity, leading to higher chance of successful nerve block.

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Anesthetics, Cardiovascular, Central nervous system, Adverse, Effects, Local anesthesia, Central actions
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