Systemic adverse reactions to local anesthetics

Abstract

Uvod:Lokalni anestetici su najčešće korišćeni lekovi u svakodnevnoj stomatološkoj i medicinskoj, a sve češće i u kozmetičkoj praksi. Danas postoji veliki broj lokalnih anestetika koji su prema strukturi podeljeni na dve grupe: estarske i amidne lokalne anestetike. Iako je njihova primena u svakodnevnom radu uglavnom bezbedna, nije isključena mogućnost pojave negativnih reakcija koje mogu biti psihogene, toksične, imunološke i specifične neželjene reakcije. Cilj: ovog rada je da ukaže na mehanizam nastanka i simptomatologiju mogućih negativnih reakcija na lokalne anestetike. Zaključak:Ukoliko dođe do pojave sistemske neželjene reakcije na lokalni anestetik, najveći problem, u kliničkoj praksi, predstavlja prepoznavanje prirode negativne reakcije i pružanje adekvatne terapije u vezi sa nastalom reakcijom.Brzina i sigurnost u prepoznavanju neželjene reakcije na lokalni anestetik, nekada mogu biti od životnog značaja za bolesnika. AbstractIntroduction: Local anesthetics are the most commonly used drugs in everyday dental and medical and increasingly in cosmetic practice. Today there are a number of local anesthetics that are divided into two groups based on their structure: ester and amide local anesthetics. Although their use in everyday work is generally safe, there is a possibility of adverse reactions that may be psychogenic, toxic, immunologic and specific adverse reactions. The aim of this work is to highlight the mechanism of occurrence and symptoms of possible adverse reactions to local anesthetics. Conclusion: If you experience systemic adverse reactions to the local anesthetic, the biggest problem in clinical practice, is a recognition of the nature of adverse reactions and providing appropriate therapy in conjunction with the resulting reaction. Speed and security to identify adverse reactions to local anesthetic can be of vital importance for the patient.

Clinical Effects of Hyperbaric Lidocaine and Bupivacaine in Spinal Anesthesia – our Experience

“…Spinal anesthesia effects of lidocain and bupivacaine unilateral block, and even death (1,2). Before using spinal anesthesia, it is important to choose the appropriate local anesthetic with dose that will later have a sufficient effect in all the necessary parameters and provide satisfaction for the patient, surgeon and anesthesiologist.…”

“…Complications which may occur under spinal anesthesia range from mild to severe and may occur perioperatively or postoperatively. Moreover, the use of local anesthetics in spinal anesthesia can cause various side effects and complications in the perioperative period such as hypotension, bradycardia, tremor, pruritus, nausea, vomiting, hearing impairment, insufficient anesthesia, paresthesia, spinal cord ischemia, total spinal anesthesia, spinal hematoma, headache, cauda equina syndrome, allergy, unilateral block, and even death ( 1 , 2 ). Before using spinal anesthesia, it is important to choose the appropriate local anesthetic with dose that will later have a sufficient effect in all the necessary parameters and provide satisfaction for the patient, surgeon and anesthesiologist.…”