History of the Development and Evolution of Local Anesthesia Since the Coca Leaf

Calatayud, J; González, A. Galán

doi:10.1097/00000542-200306000-00031

Cited by 133 publications

(97 citation statements)

References 17 publications

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“…The first known local anesthetic, cocaine 170 , induces vasoconstriction, even at small doses, by inhibition of norepinephrine uptake 171 . Modern local anesthetics (lidocaine 172 and bupivacaine 173 ) have a dose dependent effect: low concentrations cause vasoconstriction of arterioles, while high concentrations cause vasodilation.…”

Section: Iiid5 Local Anesthetics-mentioning

confidence: 99%

Anesthesia, Microcirculation, and Wound Repair in Aging

Bentov¹,

Reed²

2014

Survey of Anesthesiology

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Age related changes in skin contribute to impaired wound healing after surgical procedures. Changes in skin with age include decline in thickness and composition, a decrease in the number of most cell types and diminished microcirculation. The microcirculation provides tissue perfusion, fluid homeostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause further disruption of the microvasculature of aged skin. Perioperative management can be modified to minimize insults to aged tissues. Judicious use of fluids, maintenance of normal body temperature, pain control and increased tissue oxygen tension are examples of adjustable variables that support the microcirculation. Anesthetic agents influence the microcirculation from a combination of effects on cardiac output, arterial pressure and local micro-vascular changes. We examine the role of anesthetic management in optimizing the microcirculation and potentially improving postoperative wound repair in older persons. I. BackgroundSurgical wound repair is a major problem in the older population 1 , who are at increased risk of wound dehiscence and infection 2 . As a specific example, surgical site infections (SSI) are common (about 500,000 cases annually in the United States), lead to worse patient outcome (patients who develop SSI are twice as likely to die 3 ), and are an enormous economic burden (1-10 billion dollars annually) 4 . Many factors contribute to age related changes in skin 5 and subsequent vulnerability to impaired wound healing and infection. Changes in skin with age ( Figure 1) include a decline in epidermal and dermal thickness and composition, as well as a decrease in the number of most resident cell types. The dermalepidermal junction is flattened and the microcirculation is diminished 6 . The latter is defined as blood flow through arterioles, capillaries and venules and is the key system that affects the entire skin surface. In the aging patient, the skin's microcirculation is reduced by 40% between the ages of 20 to 70 years 7 . The microcirculation provides tissue perfusion, fluid hemostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause disruption of the skin's microcirculation as manifested by local edema resulting from vasodilation and increased vascular permeability. Summary StatementAged skin is at increased risk of poor post-operative wound healing. Changes in the cutaneous microcirculation with aging contribute to this risk. This review examines the role of anesthesia management on microcirculatory function. In this review, we will use skin as a representative organ to describe age-related changes that negatively affect the microcirculation and have subsequent impacts on wound healing and the incidence of postoperative infection. We will then examine the role of anesthesia management in minimizing detrimental effects on the microcirculation. A greater understanding of...

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Section: Iiid5 Local Anesthetics-mentioning

confidence: 99%

Anesthesia, Microcirculation, and Wound Repair in Aging

Bentov¹,

Reed²

2014

Survey of Anesthesiology

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“…Since its discovery in the sixteenth century in Spain via coca leaves, local anaesthetics have revolutionized both medical and dental practice 3 . The dental syringe is one of the most popular devices for local infiltration since its introduction in 1921 4 .…”

Section: Introductionmentioning

confidence: 99%

Facilitating Good Local Anaesthesia

Lama¹

2017

IOSR JDMS

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“…The first such use involved cocaine administration during eye surgery in 1884, and, although effective, cocaine was associated with considerable toxicities that prompted subsequent development of safer alternatives ( Figure 1) [1,2]. Today, local or regional administration of anesthetics is integral to prevention of perioperative pain [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain

Ilfeld

2013

Expert Opinion on Pharmacotherapy

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History of the Development and Evolution of Local Anesthesia Since the Coca Leaf

Cited by 133 publications

References 17 publications

Anesthesia, Microcirculation, and Wound Repair in Aging

Anesthesia, Microcirculation, and Wound Repair in Aging

Facilitating Good Local Anaesthesia

Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain

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