Local Anaesthetics

Question 1

COCAINE

Answer 1

MECHANISM
Potency 2
Na+ channel Blocker

INDICATION
medium duration effect
topical use in ENT procedures
-not much used anymore due to its strict regulations

SIDE EFFECTS

• strong vasoconstrictor effect
• cardiovascular toxicity

Question 2

LIDOCAINE

XYLOCAINE

Answer 2

MECHANISM
Potency 4
Na+ channel Blocker

INDICATION
medium duration, short onset
vasodilation effect!!!
-infiltration anaesthesia
-block anaesthesia
-topical (surface) anaesthesia

SIDE EFFECTS

• TNS (transient neurologic symptoms) are frequent in spinal anaesthesia
• agitation, tremor and hallucinations
• hypotension, low HR, arrhythmia

Question 3

CHLOROPROCAINE

Answer 3

MECHANISM
Na+ channel Blocker

INDICATION
short onset and action
-spinal anaesthetics
-emergency cesaerian section
-vasoconstriction!!

SIDE EFFECTS
-no TNS in spinal anaesthesia, frequently reported with lidocaine use.

Question 4

PROCAINE

NOVOCAINE

Answer 4

MECHANISM
Potency 1
Na+ channel Blocker

INDICATION
short duration effect
-like chloroprocaine (not used epidurally)

SIDE EFFECTS

• restlessness
• shaking and tremor
• convulsions

Question 5

BENZOCAINE

Answer 5

MECHANISM
Na+ channel Blocker

INDICATION
only surface use (highly lipophilic!)
-local anaesthesia of oral/pharyngeal mucous membranes
-otic pain

SIDE EFFECTS
-methemoglobinemia: reduced ability of the red blood cell to release oxygen to tissues

Question 6

ARTICAINE

Answer 6

MECHANISM
Na+ channel Blocker

INDICATION
medium duration (lipophilic!)
-dental surgery

SIDE EFFECTS
not significant

Question 7

MEPIVACAINE

Answer 7

MECHANISM
Potency 2
Na+ channel Blocker

INDICATION
medium duration
-infiltration anaesthesia
-regional anaesthesia

SIDE EFFECTS
not significant

Question 8

BUPIVACAINE

Answer 8

MECHANISM
Potency 16!!!!!
Na+ channel Blocker

INDICATION
long duration effect
-spinal anaesthesia
-epidural infusion in postoperative pain
-epidural labor pain control

SIDE EFFECTS

• cardiotoxic
• no TNS (transient neurologic symtoms)

Question 9

LEVOBUPIVACAINE

Answer 9

MECHANISM
Potency 16!!!!
Na+ channel Blocker

INDICATION
long duration effect
-spinal anaesthesia
-epidural infusion in postoperative pain
-epidural labor pain control

SIDE EFFECTS
-less cardiotoxic –> better than its racemix mate Bupivacaine

Question 10

ROPIVACAINE

Answer 10

MECHANISM
Potency 16!!!
Na+ channel Blocker

INDICATION
long duration effect
-high volume peripheral nerve blocks
-epidural labor pain control

SIDE EFFECTS
-low cardiotoxicity

Question 11

TETRACAINE

Answer 11

MECHANISM
Potency 16!!!
Na+ channel Blocker

INDICATION

• long duration effect
• spinal anaesthetics

SIDE EFFECTS
not significant

Question 12

PRILOCAINE

Answer 12

MECHANISM
Na+ channel Blocker

INDICATION
-spinal anaesthesia (in Europe)

SIDE EFFECTS
not significant