Clinical Case Database / Category: Practical Procedure
Local anaesthetics and their uses in Emergency Medicine
Publication details
Christopher J. Blakeley FRCS FCEM
Foundation Years Journal, volume 1, issue 6, p.2 (123Doc Education, London, October 2007)
Abstract
The concept of local anaesthesia was first introduced by the ophthalmologist Carl Koller in 1884 in conjunction with his work with Sigmund Freud on the systemic and local effects of cocaine. The concept of regional anaesthesia was introduced by William Halstead the following year. At the turn of the century Einhorn introduced the local anaesthetic procaine which remained the drug of choice until the introduction of lidocaine (lignocaine) in 1943. In 1973 bupivacaine, a longer acting local anaesthetic, was added to the growing list of available agents.
Local anaesthetics produce safe and effective analgesia in a wide variety of clinical settings from the simple insertion of a venous cannula to a femoral nerve block in the trauma patient.
The mode of action of local anaesthetics is to reduce membrane permeability to sodium. They act firstly upon small unmyelinated C fibres, thus pain and temperature are the first sensory modalities to be affected.
Doctors of all specialities must therefore be fully aware of the agents available, the techniques described and safety issues with regard to avoiding local anaesthetic toxicity.
Access the Clinical Cases Database
A subscription is required to read the full article. Please subscribe using one of the options below.
| Product | Price | Subscription | |
|---|---|---|---|
| Foundation Years Clinical Cases Database | £29.00 | 6 months | |
| Foundation Years Clinical Cases Database | £39.00 | 12 months |
Authors
Christopher J. Blakeley FRCS FCEM (Corresponding author)
Accident & Emergency Consultant
Emergency Department
Mayday University Hospital
London Road
Croydon
CR7 7YE
References
Disclaimers
Conflict Of Interest
The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).
Financial Statement
The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.
Patient Consent statement
All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.
Animal & Human Rights
When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.
About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.