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Huntal Napoleon
Local Anesthesia
Local anesthetics work by
producing nerve conduction
blockade at the level of nerve
membrane receptors.
Indications
a. Anesthesia for surgical procedures
b. Anesthesia for wounds that require
irrigation, debridement, and/or
repair
Advantage
The patient can remain conscious, and by
doing so provides assurance of a safe airway
and avoids complications caused by
anaesthetic interference with breathing
function. In contrast, most techniques for
general anaesthesia interfere with the control
of at least three major systems:
consciousness, cardiovascular and
respiratory function. For many patients it is
the loss of control of these functions that
causes them the greatest anxiety in relation
to surgery.
Contraindications
a. Hipersensitivity
b. Epinephrine should not be used at
anatomic sites supplied by endarteries (fingers, toes, nose, ears,
penis) or in infection-prone wounds
(animal/human bites, contaminated
wounds).
Local Anesthesi
Choose from the above chart and tailor
choice to individual patient based on
the duration of procedure; time to onset;
and location, type, and extent of wound.
Long-and short-acting anesthetics can
be mixed in a 50:50 ratio to achieve
benefits of both.
Local Anesthesia
No. Local Anesthetic
1.
2.
3.
4.
Bupivacaine (Marcaine)
Lidocaine (Xylocaine)
Procaine (Novocaine)
Tetracaine (Pontocaine)
Onset
slow
rapid
slow
slow
With epi
2.5
5.0
6.0
1.5
3.5
7.0
9.0
2.5
With epi
2.0-4.0
0.5-2.0
0.25-0.5
2.0-3.0
4.0-6.0
1.0-4.0
0.5-1.0
2.0-4.0
Technique
Technique:
a. Sterile prep wound with antiseptic such as
Betadine, cleanse with alcohol swab.
b. Stretch skin taut to facilitate penetration,
and directly infiltrate local anesthetic
through wound edges and inside wound
with a long 25 gauge needle; minimize
needle sticks by orienting needle
longitudinally along axis of wound and
injecting beneath skin edges
c. Inject the anesthetic slowly
TERIMAKASIH