Abstract
The use of local and regional anesthesia in surgical practice is considered to be safe, certainly much safer than the use of general anesthesia. For example, a 1955 survey of local anesthesia used for dental procedures found only two deaths in an estimated 90 million cases over a span of 10 years [1]. Such a statistic can lull one into an inappropriate sense of security. Significant complications other than death can and do occur with the use of local anesthetics which can cause considerable difficulty for patients [2]. The incidence of adverse reactions to regional blocks in a hospital setting is approximately 0.2% [3] while the incidence of adverse responses to dental local anesthesia may be as high as 2.5% [4]. The latter figure includes a substantial number of psychological reactions. It is imperative that any physician utilizing local and regional anesthesia understand the potential risks and be prepared to manage complications. This chapter covers local and systemic adverse reactions including allergy, drug interactions, and reactions peculiar to certain drugs, and also reviews precautions that one should take to prevent difficulties.
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References
Seldin HM, Recant BS (1955) The safety of anesthesia in the dental office. J Oral Surg 13: 199–208
Laskin DM (1984) Diagnosis and treatment of complications associated with local anesthesia. Int Dent J 34: 232–237
Dhuner KG (1972) Frequency of general side reactions after regular anesthesia with me- pivacaine with and without vasoconstrictor. Acta Anesthesiol Scand Suppl 48: 23–52
Persson G (1969) General side effects of local dental anesthesia with special reference to catecholamines as vasoconstrictors and to the effect of some premedicaments. Acta Ondontol Scand Suppl 53: 1–141
Thomas RM (1982) Local anesthetic agents and regional anesthesia of the face. J Assoc Milit Dermatol 8: 28–33
Abadin A (1975) Capsule anesthesiology: use of local anesthetics in dermatology. J Der-matol Surg Oncol 1: 65–70
Farber GA (1982) Anesthesia for skin surgery. In: Epstein E, Epstein E Jr (eds) Skin surgery, 5th edn. Thomas, Springfield, pp 54–64
Robinson JK (1979) Reply to letter to the editor. J Dermatol Surg Oncol 5: 945
Moore DC (1981) Regional block, a handbook for use in the clinical practice of medicine and surgery. Thomas, Springfield, pp 19–43
Milgram P, Fiset L (1986) Local anaesthetic adverse effects and other emergency problems in general dental practice. Int Dent J 36: 71–76
Buckley JA, Ciancio SG, McMullen JA (1984) Efficacy of epinephrine concentration in local anesthesia during periodontal surgery. J Periodontol 5: 653–657
Henderson JJ, Nimmo WS (1983) Practical regional anesthesia. Blackwell, Oxford, pp 96–102
Baker JD, Blackman BB (1985) Local anesthesia. Clin Plast Surg 12: 25–31
Foster CA, Aston SI (1983) Propranolol-epinephrine interaction, a potential disaster. Plast Reconstr Surg 72: 74–78
Dzubow LM (1986) The interaction between propranolol and epinephrine as observed in patients undergoing Mohs surgery. J Am Acad Dermatol 15: 71–75
Winton GB (1988) Anesthesia for dermatologic surgery. J Dermatol Surg Oncol 14: 41–54
Ralston DH, Schnider SM (1968) The fetal and neonatal effects of regional anesthesia and obstetrics. Anesthesiology 48: 34–64
Gormley DE (1990) Cutaneous surgery and the pregnant patient. J Am Acad Dermatol 23: 269–279
Martin IC (1988) Medical problems with local analgesia. Dent Update Suppl 2: S15–S18
Ecker RI (1980) More on local anesthesia of the digits. J Dermatol Surg Oncol 6: 165
Grabb WC (1979) A concentration of 1:500 000 epinephrine in a local anesthetic solution is sufficient to provide excellent hemostasis. Plast Reconstr Surg 63: 834
Graham WP III (1983) Anesthesia in cosmetic surgery. Clin Plast Surg 10: 285–287
Siegel RJ, Vistnes LM, Iverson RE (1973) Effective hemostasis with less epinephrine. Plast Reconstr Surg 51: 129–133
Robinson JK (1979) Advantages and technique of inducing local anesthesia with a small-bore, angled needle. J Dermatol Surg Oncol 5: 465–466
Stegman SJ, Tromovitch TA, Glogau RG (1982) Basics of dermatologic surgery. Year-book Medical Publishers, Chicago, pp 23–31
Grekin RC, Auletta MJ (1988) Local anesthesia in dermatologic surgery. J Am Acad Dermatol 19: 599–614
Stewart JH, Cole GW, Klein JA (1989) Neutralized lidocaine with epinephrine for local anesthesia. J Dermatol Surg Oncol 15: 1081–1083
Stewart JH, Chinn SE, Cole GW, Klein JA (1990) Neutralized lidocaine with epinephrine for local anesthesia II. J Dermatol Surg Oncol 16: 842–845
Gordh T (1979) Complications and their treatment. In: Eriksson E (ed) Illustrated hand-book in local anesthesia. Lloyd-Luke, London, pp 16–19
Cousins MJ, Bridenbaugh PO (1988) Neural blockade in clinical anesthesia and manage-ment of pain. Lippincott, Philadelphia, pp 130–131
Chan Tyk, Davidson T (1990) Femoral nerve block after intra-operative subcutaneous bupivacaine injection. Anaesthesia 45: 163–164
Stromberg BV (1985) Regional anesthesia in head and neck surgery. Clin Plast Surg 12: 123–126
Rettinger G, Christ P (1989) Visual loss following intranasal injection. Rhinology Suppl 9: 66–72
Bridenstein JA (1989) Lidocaine during liposuction. J Dermatol Surg Oncol 15: 775–776
Mulroy MF (1989) Regional anesthesia: an illustrated procedural guide. Little Brown, Boston, pp 31–41
De Fazio CA (1981) Local anesthetics: action, metabolism, and toxicity. Otolaryngal Clin North Am 14: 515–519
Maloney JM III, Lertora JJL, Yarborough J et al. (1982) Plasma concentrations of lidocaine during hair transplantation. J Dermatol Surg Oncol 8: 950–954
Wildsmith JAW, Armitage EN (1987) Principles and practice of regional anaesthesia. Churchill Livingstone, Edinburgh, pp 28–29
De Jong RH (1977) Local anesthesia, 2nd edn. Thomas, Springfield, pp 112–114
Verill PJ (1975) Adverse reactions to local anesthetics and vasoconstrictor drugs. Practicioner 214: 380
Fregert S, Tegner E, Thein I (1979) Contact allergy to lidocaine. Contact Dermatitis 5: 185–188
Adriani J, Zepernick R (1981) Allergic reactions to local anesthetics. South Med J 74: 694–699
Ruzicka T, Gerstmeier M, Przybilla B, Ring J (1987) Allergy to local anesthetics: comparison of patch test with prick and intradermal test results. J Am Acad Dermatol 16: 1202–1208
Aldrete JA, Johnson DA (1969) Allergy to local anesthetics. JAMA 207: 356–357
DeShazo RD, Nelson HS (1979) An approach to the patient with a history of local anesthetic hypersensitivity: experience with 90 patients. J Allergy Clin Immunol 63: 387–394
Incaudo G, Schatz M, Patterson R, Rosenberg M et al. (1978) Administration of local anesthetics to patients with a history of prior adverse reaction. J Allergy Clin Immunol 61: 339–345
Levy SM, Baker KA (1986) Considerations in differential diagnosis of adverse reactions to local anesthetic: report of a case. J Am Dent Assoc 113 (2): 271–273
Chin YC, Brecht K, Das Gupta DS, Mhoon E (1986) Myocardial infarction with topical cocaine anesthesia for nasal surgery. Arch Otolaryngol Head Neck Surg 112: 988–990
Gordon BR (1987) Topical cocaine nasal anesthesia (Letter). Arch Otolaryngol Head Neck Surg 113: 211
Das Gupta DS (1987) Topical cocaine nasal anesthesia (Reply). Arch Otolaryngol Head Neck Surg 113: 211
Reynolds F (1987) Adverse effects of local anesthetics. Br J Anaesthesia 59: 78–95
Shira RB (1988) The use of amide local anesthetics in patients susceptible to malignant hyperthermia. Oral Surg Oral Med Oral Pathol 66: 405–415
Zenz M, Panhans C, Niesel HC, Kreuscher H (1988) Regional anesthesia. Year Book Medical Publishers, Boca Raton, pp 15–16
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Winton, G.B. (1993). Local Anesthesia and Regional Anesthesia. In: Harahap, M. (eds) Complications of Dermatologic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77415-7_1
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DOI: https://doi.org/10.1007/978-3-642-77415-7_1
Publisher Name: Springer, Berlin, Heidelberg
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