Abstract
The mechanism for neurotoxicity produced by local anesthetics (LA) has been understood to be produced by the blockade of neural relays, which normally inhibit amygdaloid activity. The generalized depression and muscle rigidity seen before and after convulsions in such cases form part of the suppressive or inhibitory influences on motor pathways [1,2]. Since LA reach the brain by various routes, most commonly by the circulation, high blood levels can be either the result of overdosage or accidental injection into the lumen of a vein.
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References
Usubiaga JE, Wikinski J, Ferrero R et al. (1968) Local anesthetic-induced convulsions in man. An electroencephalographic study. Anesth Analg 45: 611
DeJong RH (1977) Local anesthetics. Thomas, Springfield, Chap 8
Bourne JG (1970) Deaths with dental anaesthetics. Anaesthesia 25: 473
Tomlin PJ (1974) Death in outpatient dental anesthetic practice. Anaesthesia 29: 551
Malmin O (1974) The shot that kills: deaths in the dental chair. Exposition, Hicksville, pp 11–17
Selden HM (1967) Reactions to local anesthetics. J Mich Dent Assoc 49: 41
Portman J (1970) Deaths with dental anaesthetics. Lancet 1: 627–647
Wikinski JA, Usubiaga JE, Morales RL et al. (1970) Mechanism of convulsions elicited by local anesthetic agents. Anesth Analg 49: 504
Moore DC (1955) Complications of regional anesthesia. Thomas, Springfield, pp 6–22
Aldrete JA, Narang R, Sada T et al (1977) Reverse carotid blood flow — a possible explanation for some reactions to local anesthetics. J Am Dent Assoc 94: 1142
Aldrete J A, Nicholson J, Sada T et al. (1977) Cephalic kinetics of intra-arterially injected lidocaine. Oral Surg 44: 167
Aldrete J A, Romo-Salas F, Arora S et al. (1978) Reverse arterial blood flow as a pathway for central nervous system toxic response following injection of local anesthetics. Anesth Analg 57: 428
Penn RD, Walser R, Ackerman L (1977) Cerebral blood volume in man: computer analysis of a computerized brain scan. JAMA 172: 1493–1496
Munson ES,GutnickMJ,Wagman IH (1970) Local anesthetic drug-induced seizures in rhesus monkeys. Anesth Analg 49: 986
Bedeyneck JL Jr, WeinsteinKN, Kah RE et al. (1966) Ventricular tachycardia: control by intermittent administration of lidocaine hydrochloride. JAMA 198: 553
Covino BG (1978) Systemic toxicity of local anesthetic agents (editorial). Anesth Analg 57: 387
Foldes FF, Molloy R, McNall PG, Koukal LR (1960) Comparison of toxicity of intravenously-given local anesthetic agents in man. JAMA 172: 1478
Bromage PR, Robson JG (1961) Concentration of lignocaine in the blood after intravenous, intramuscular, epidural and endotracheal administration. Anaesthesia 16: 461
Wikinski J A et al. (1980) General anesthesia with intravenous procaine. In: Aldrete JA, Stanley TH (eds) Trends in intravenous anesthesia. Year Book Publishers, Chicago, p 198
Steinhaus JE, Howland DE (1958) Intravenously administered lidocaine as a supplement to nitrous oxide-thiobarbiturate anesthesia. Anesth Analg 37: 40
Aldrete JA, Fraser JG (1966) Intravenous lidocaine as a supplement to nitrous oxide anesthesia for radical middle ear surgery. Can Anaesth Soc J 13: 397
Tucker GT, Moore DC, Bridenbaugh PO, Bridenbaugh LD, Thompson GE (1972) Systemic absorption of mepivacaine in commonly-used regional block procedures. Anesthesiology 37: 277
Munson ES, Tucker WK, Ausimach B et al. (1975) Etidocaine, bupivacaine, and lidocaine seizure thresholds in monkeys. Anesthesiology 42: 471
Tucker GT, Mather LE (1975) Pharmacokinetics of local anaesthetic agents. Br J Anaesthesiol 47: 213
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© 1984 Springer-Verlag Berlin Heidelberg
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Aldrete, J.A. (1984). Reverse Arterial Blood Flow: A Mechanism for Neurotoxicity from Local Anesthetics. In: Wüst, H.J., Zindler, M., d’Arcy Stanton-Hicks, M. (eds) Neue Aspekte in der Regionalanaesthesie 3. Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine, vol 158. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69453-0_6
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DOI: https://doi.org/10.1007/978-3-642-69453-0_6
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