TOPICAL, LOCAL, AND REGIONAL ANESTHESIA AND ANESTHETICS

Course overview

NERVE IMPULSE TRANSMISSION OCCURS WHEN VOLTAGE-GATED SODIUM CHANNELS ON THE NEURONAL MEMBRANE OPEN, ALLOWING A MASSIVE INFLUX OF SODIUM. THIS CAUSES MEMBRANE DEPOLARIZATION AND PROPAGATION OF THE IMPULSE. LOCAL ANESTHETICS BLOCK NERVE IMPULSE TRANSMISSION IN THE PERIPHERAL AND CENTRAL NERVOUS SYSTEM WITHOUT CAUSING CENTRAL NERVOUS SYSTEM DEPRESSION OR ALTERED MENTAL STATUS. THE BLOCK GENERALLY OCCURS IN A STEPWISE SEQUENCE DEPENDING ON THE CONCENTRATION AND VOLUME OF THE LOCAL ANESTHETIC, WITH AUTONOMIC IMPULSES BLOCKED FIRST, THEN SENSORY IMPULSES, AND FINALLY, MOTOR IMPULSES. LOCAL ANESTHETICS ARE USED TO ANESTHETIZE SKIN, SUBCUTANEOUS TISSUE, AND PERIPHERAL NERVES FOR INVASIVE OR SURGICAL PROCEDURES. THIS ACTIVITY OUTLINES THE INDICATIONS, MECHANISM OF ACTION, ADMINISTRATION METHODS, SIGNIFICANT ADVERSE EFFECTS, CONTRAINDICATIONS, TOXICITY, AND MONITORING, OF TOPICAL, LOCAL, AND REGIONAL ANESTHETIC AGENTS SO PROVIDERS CAN DIRECT PATIENT THERAPY WHEN INDICATED AS PART OF THE INTERPROFESSIONAL TEAM.