Surgical Anesthesia
Pharmacology and Indications
Licocaine
Licocaine is a type of medication used with an aim of numbing tissues and nerves within a given area of the body, which provides that anesthetic effect for the body. The most popular brand names for this particular drug are xylocaine and lignocaine. Some of the common effects associated with this particular medication include drowsiness, muscle twitching, nausea, and confusion (1). The severity of the side effects depends wholly on a patient’s reaction to the chemical composition of the drug. Regarding its mode of action, licocaine works by blocking the voltage-gated Na+ channels, which are cell membranes responsible for propagating signals within the brain. Blockage of the signal helps in ensuring that the pain signals do not reach the brain, which creates that anesthetic effect. The main indication associated with licocaine relates to its usage as a local anesthesia including intrathecal for adults and children over the age of 12 years (5). In the event that a patient may use this particular anesthetic with Digoxin (Digoxina®), the notable side effects to expect include loss of appetite and nausea. Usage of the same anesthetic with Enoxaparin (Clexane®) may lead to the occurrence of side effects that include coughing up of blood and pain within the abdomen. Lastly, usage of this anesthetic with Thyroxine (Eutirox®) may lead to high fever for the patient involved.
Mepivacaine
Mepivacaine is one of the commonly used anesthetic, as it has the capacity of rapid onset after application within a given area. The time take for the drug to take effect is less than 2 minutes and lasts for a maximum period of 30 minutes, which is somewhat lower when compared to other anesthetics (5). The common brand names for this particular anesthesia are Carbocaine and Polocaine approved within the federal laws in the United States. The main side effects associated with mepivacaine include metallic taste in the mouth, ringing in the ears, slow heart rate, fever, tremors, and pain during urination. Regarding its mode of action, mepivacaine works by stabilizing the neuronal membrane within the body. The stabilization of this particular membrane helps in preventing the transmission of nerve impulses to the brain, which may include the impulse associated with pain. The indication when using this particular anesthesia is that it is utilized for local dental procedures through infiltration and blocking of the nerves for both adults and children. The side effects associated with usage of this anesthetic with Digoxin (Digoxina®) may create a situation where patients experience an irregular heart rate that may affect the level of blood flow within the body. For Enoxaparin (Clexane®), the side effects include higher risks of cardiac arrest or heart failure due to inability for the body to handle the chemical composition of both drugs. Lastly, the side effects of this anesthetic with Thyroxine (Eutirox®) include adrenal insufficiency, confusion, and high fever in some of the most severe cases.
Ropivacaine
Ropivacaine, which is traded within the brand name Naropin, is a type of anesthesia belonging to the amino amide group, which produces that anesthetic effect by blocking the generation conduction of impulses within the nervous system. That creates an avenue allowing for an increase in the overall threshold associated with electrical excitation in the nerve, which would help in propagation of all impulses directed to the brain. Consequently, this enhances the ability for the brain to avoid impulses of pain, as the drug provides the body with an anesthetic effect. However, the loss of impulses does not only affect pain but also affects other aspects of the body including temperature, touch, and muscle tone. The notable side effects associated with ropivacaine include burning sensation, fever, itch, and increased back pain. Regarding its mode of action, ropivacaine does not work in diverting the impulses within the nerves but instead works towards slowing down the rate of impulses moving into the brain. The main indication associated with the drug is that it is suitable when dealing with peripheral nerve block and caudal epidural for both adults and children due to the minimal effects. In this case, the side effects of using this anesthetic with Digoxin (Digoxina®) may include vomiting and diarrhea, as well as, some cases of blood in the stool. Usage of the drug with Enoxaparin (Clexane®) may lead to side effects that include confusion, diarrhea, and nausea, which vary depending on the reactions that the patient may have towards given elements of the two drugs. Lastly, mixture of this anesthetic with Thyroxine (Eutirox®) leads to loss of appetite and weight loss especially in some of the severe cases reported.
Levobupivacaine
Levobupivacaine, traded within the brand name Chirocaine, acts as a local anesthesia within the category of amino amide group of drugs, which helps in enhancing the capacity for the brain to protect the body from exposure to pain. According to research conducted on this particular drug, it is 13% less potent when compared to other anesthetics, which makes it suitable for use when dealing with children and infants (2). In addition, levobupivacaine also has a longer duration, as it has the capacity of lasting up to four hours thereby indicates the viability of its recommendation for children. The mode of action for this particular drug is that it helps in blocking the nerve systems within the body, which reduces the abilities for nerves to send pain impulses to the brain. Regarding its side effects, levobupivacaine may cause tremor, dizziness, tingling around the mouth, and loss of consciousness in more severe cases (4). The key indication for levobupivacaine is that it is to be administered as a local anesthesia focused on infiltration analgesia among younger children. In this case, the side effects of using this anesthetic with Digoxin (Digoxina®) include visual or hearing disturbances depending on the severity of the side effects recorded. Usage of the anesthetic with Enoxaparin (Clexane®) leads to agitation, mental stress and depression, which may affect one’s capacity to handle some their daily activities. Lastly, usage of the anesthetic with Thyroxine (Eutirox®) may lead to shortness of breath attributed to the elevated heart rate.
Articaine
Articaine is one of the common types of anesthetics used in majority of the European countries, as well as, other countries around the world. Similar to other anesthetic drugs used around the world, articaine helps in enhancement of pain control during dental procedures, which is important, as it provides the dentists with a platform allowing them to reduce patients’ reaction to pain. One of the key advantages of using articaine as the preferred anesthesia is that it is readily available within the local pharmaceutical markets around the world. Articaine operates within the brand name Septocaine, which is a registered brand in majority of the countries around the world. The mode of action for articaine is that it works by blocking the nerve signals within the expected part of the body with an aim of controlling the level of pain felt. Regarding its side effects, articaine may cause headaches, gingivitis, and facial edema, which are the major side effects associated with this particular drug (1). The key indication for this particular drug is that articaine is to be used as a conductive anesthesia when undertaking a wide range of dental procedures regardless of their complexities. In this case, usage of the anesthetic with Digoxin (Digoxina®) may lead to the development of side effects that include higher acute sense of sensual activities. However, the level of sense towards sensual activities depends on the chemical reactions that the patients may have for these two drugs. In addition, usage of the anesthetic with Enoxaparin (Clexane®) may cause increased bleeding especially when embarking on a given surgical procedure. Mixture of the anesthetic with Thyroxine (Eutirox®) may increase the chances of heart failure for given patients especially when dealing with patients that suffer from varying heart-related conditions.
Prilocaine
Prilocaine works as an injectable anesthesia, which is common in dental procedures due to the mild effect that it may have on the lining of the mouth. The anesthetic drug operates within the brand name Citanest, which is a brand that is registered within the United States. One key element to note is that prilocaine works within the same capacity as lidocaine, as lidocaine is the main element used in the preparation of this particular anesthesia. In addition, it is equally important to note that prilocaine has a melting point of below room temperature, which makes it suitable to use as a cream especially when dealing with on-skin procedures. Prilocaine helps in stabilization of the neuronal membranes through the procedure associated with inhibitation of ionic fluxes (3). These fluxes play a key role in the conduction of impulses towards the brain thereby meaning that their inhibitation may hinder the sending of pain impulses to the brain with an aim of producing that anesthetic effect. Some of the notable side effects associated with prilocaine include difficulty in swallowing, skin rash, tightness in the chest, and troubled breathing. The key indication for this particular is that the anesthesia can only be used when dealing with normal and intact skin as a local analgesia. In this case, the notable side effect associated with usage of this drug with Digoxin (Digoxina®) is development of other medical conditions that include anemia and convulsions. The side effects to expect through usage of this anesthetic with Enoxaparin (Clexane®) include development of atrial fibrillation and pneumonia. Lastly, the effect of using this anesthetic with Thyroxine (Eutirox®) is swelling of the tongue and face with the swelling depending wholly on the severity of the chemical reactions for the patients involved.
Bupivacaine
Bupivacaine is the only type of spinal anesthesia used when undertaking particular medical procedures especially when dealing with injuries affecting the brain or other vital organs. The anesthetic drug is protected under the brand name Marcaine, which is a registered brand within the United States and other European countries. That creates a numbing effect for specific areas of the body depending on the areas of focus, which enhances the possibilities of undertaking effective surgical procedures. The anesthetic focuses on reducing the action potential for the nerves, which reduces their capacity to send pain impulses to the brain (4). The major side effects associated with this particular anesthesia include respiratory paralysis and cardiovascular effects. The key indication for his particular anesthesia is that bupivacaine helps in dealing with injuries associated with the spine, as this is a spinal anesthesia. The main side effect of using this anesthetic with Digoxin (Digoxina®) is blurred vision among the patients involved especially in cases where the anesthetic is used in dental surgical procedures. The mixture of this anesthetic with Enoxaparin (Clexane®) creates a situation where patients may experience increased bleeding. Lastly, mixture of the anesthetic with Thyroxine (Eutirox®) exposes patients to heart palpitations and abdominal pain.
Tetracaine
Tetracaine is a type of local anesthesia within the ester group attributed to its vast functionality when dealing with both minor and major surgical procedures. The drug may take effect within four minutes and lasts for 30 minutes to three hours depending on the dosage level. Tetracaine operates within the brand names Pontocaine, Ametop, and Dicaine, which are brands that have been registered within different countries. As opposed to some of the other anesthetic drugs, usage of tetracaine focuses on injection of the anesthesia within the spinal canal's epidural space. Regarding its mode of functionality, tetracaine helps in altering the overall functionality of ryanodine receptors, which distorts the release of calcium into the blood system thereby altering the sending of impulses to the brain (2). The major side effects associated with this anesthesis include chest pain and dizziness in some of the severe cases. The key indication for this particular anesthetic drug is that it should be used for IV cannulation in children. In this case, the side effects of using this anesthetic with Digoxin (Digoxina®) include increased irritability and confusion. Usage of the same anesthetic with Enoxaparin (Clexane®) may cause cases of dizziness and insomnia for the patients involved. Lastly, usage of this anesthetic with Thyroxine (Eutirox®) may cause hyperactivity for the patients involved due to an elevated heart rate.
Benzocaine
Benzocaine is a local anesthesia used in pain and cough drops with an aim of relieving pain for the patients involved. Some of the common brand names for this particular anesthesia include Anbesol, and Cepacol. Benzocaine is used when undertaking minor surgical procedures, as it has a minimal action time in enhancing the overall process of pain reduction. Regarding its mode of action, benzocaine focuses on inhibiting the voltage-dependent sodium channels (VDSCs) within the membranes within the nerves (2). That helps in propagating the action potential for the nerves to send impulses towards the brain. Consequently, this creates that anesthetic effect for the body system relieving it of any pain contributing one becoming uncomfortable. Some of the side effects associated with benzocaine include irregular heartbeats, seizures, and depression. The key indication for this particular anesthesia is that it should be used for children over the age of 2 years attributed to some of the key side effects identified. The side effects of using this anesthetic with Digoxin (Digoxina®) include loss of appetite, nausea and vomiting. In some cases, patients may experience diarrhea, which acts as a clear indication of the high effects associated with the two chemicals in the body system. Mixture of the anesthetic with Enoxaparin (Clexane®) may cause confusion, diarrhea, and nausea with the levels depending on the reaction levels. Lastly, mixture of the anesthetic with Thyroxine (Eutirox®) causes fever, hypoglycemia, and heart failure in some of the severe cases.
Bibliography
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