Biomaterial Database

[Prevention of toxic accidents of local anesthetics]. 1988

K Samii

Département d'Anesthésiologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre.

The prevention of toxic accidents due to local anesthetics is simple. The doses used must be carefully selected according to the drug chosen, the areas to be anaesthetized, and whether or not the local anaesthetic solution contains adrenaline. Continuous infusions of local anaesthetics should be used with great care. Bupivacaine must be avoided for intravenous regional anaesthesia, as well as in patients with hyperkaliemia or severe myocardiopathy with a high risk of arrhythmia. Diazepam is a useful premedication but cannot prevent toxic accidents. Using a test dose of adrenaline to detect accidental vascular puncture is simple, but not foolproof (patients treated with beta-blockers, obstetrical cases). The slow injection of local anaesthetics is the best way of preventing this type of accident. Finally, the technique for intravenous regional anaesthesia must be very strict.

UI	MeSH Term	Description	Entries
D007275	Injections, Intravenous	Injections made into a vein for therapeutic or experimental purposes.	Intravenous Injections,Injection, Intravenous,Intravenous Injection
D011229	Preanesthetic Medication	Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.	Medication, Preanesthetic,Medications, Preanesthetic,Preanesthetic Medications
D002045	Bupivacaine	A widely used local anesthetic agent.	1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D003975	Diazepam	A benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant, and amnesic properties and a long duration of action. Its actions are mediated by enhancement of GAMMA-AMINOBUTYRIC ACID activity.	7-Chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one,Apaurin,Diazemuls,Faustan,Relanium,Seduxen,Sibazon,Stesolid,Valium
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000765	Anesthesia, Conduction	Injection of an anesthetic to inhibit nerve transmission in a specific part of the body.	Anesthesia, Regional,Conduction Anesthesia,Regional Anesthesia
D000779	Anesthetics, Local	Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.	Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor