Local anesthetic in the context of "Episiotomies"

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⭐ Core Definition: Local anesthetic

A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes unconsciousness. Local anesthetics are most commonly used to eliminate pain during or after surgery. When it is used on specific nerve pathways (local anesthetic nerve block), paralysis (loss of muscle function) also can be induced.

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👉 Local anesthetic in the context of Episiotomies

Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is usually performed during the second stage of labor to quickly enlarge the aperture, allowing the baby to pass through. The incision, which can be done from the posterior midline of the vulva straight toward the anus or at an angle to the right or left (medio-lateral episiotomy), is performed under local anesthetic (pudendal anesthesia), and is sutured after delivery.

Its routine use is no longer recommended, as perineal massage applied to the vaginal opening is an alternative to enlarge the orifice for the baby. It was once one of the most common surgical procedures specific to women. In the United States, as of 2012, it was performed in 12% of vaginal births. It is also widely practiced in many parts of the world, including Korea, Japan, Taiwan, China, and Spain in the early 2000s.

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Local anesthetic in the context of Cocaine

Cocaine is a central nervous system stimulant and tropane alkaloid derived primarily from the leaves of two coca species native to South America: Erythroxylum coca and E. novogranatense. Coca leaves are processed into cocaine paste, a crude mix of coca alkaloids from which cocaine base is isolated and converted to cocaine hydrochloride. Cocaine was once a standard topical medication as a local anesthetic with intrinsic vasoconstrictor activity, but its high abuse potential, adverse effects, and cost have limited its use and led to its replacement by other medicines.

Street cocaine is commonly snorted, injected, or smoked as crack cocaine, with effects lasting up to 90 minutes depending on the route. Cocaine acts pharmacologically as a serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI), producing reinforcing effects such as euphoria, increased alertness, concentration, libido, and reduced fatigue and appetite.

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Local anesthetic in the context of Skin biopsy

Skin biopsy is a biopsy technique in which a skin lesion is removed to be sent to a pathologist to render a microscopic diagnosis. It is usually done under local anesthetic in a physician's office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists. Skin biopsies are also done by family physicians, internists, surgeons, and other specialties. However, performed incorrectly, and without appropriate clinical information, a pathologist's interpretation of a skin biopsy can be severely limited, and therefore doctors and patients may forgo traditional biopsy techniques and instead choose Mohs surgery.

There are four main types of skin biopsies: shave biopsy, punch biopsy, excisional biopsy, and incisional biopsy. The choice of the different skin biopsies is dependent on the suspected diagnosis of the skin lesion. Like most biopsies, patient consent and anesthesia (usually lidocaine injected into the skin) are prerequisites.

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Local anesthetic in the context of Anesthetic

An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad classes: general anesthetics, which result in a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness.

A wide variety of drugs are used in modern anesthetic practice. Many are rarely used outside anesthesiology, but others are used commonly in various fields of healthcare. Combinations of anesthetics are sometimes used for their synergistic and additive therapeutic effects. Adverse effects, however, may also be increased. Anesthetics are distinct from analgesics, which block only sensation of painful stimuli. Analgesics are typically used in conjunction with anesthetics to control pre-, intra-, and postoperative pain.

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Local anesthetic in the context of Epidurals

Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method of medication administration in which a medicine is injected into the epidural space around the spinal cord. The epidural route is used by physicians and nurse anesthetists to administer local anesthetic agents, analgesics, diagnostic medicines such as radiocontrast agents, and other medicines such as glucocorticoids. Epidural administration involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. The technique of intentional epidural administration of medication was first described in 1921 by the Spanish Aragonese military surgeon Fidel Pagés.

Epidural anaesthesia causes a loss of sensation, including pain, by blocking the transmission of signals through nerve fibres in or near the spinal cord. For this reason, epidurals are commonly used for pain control during childbirth and surgery, for which the technique is considered safe and effective, and is considered more effective and safer than giving pain medication by mouth or through an intravenous line. An epidural injection may also be used to administer steroids for the treatment of inflammatory conditions of the spinal cord. It is not recommended for people with severe bleeding disorders, low platelet counts, or infections near the intended injection site. Severe complications from epidural administration are rare, but can include problems resulting from improper administration, as well as adverse effects from medicine. The most common complications of epidural injections include bleeding problems, headaches, and inadequate pain control. Epidural analgesia during childbirth may also impact the mother's ability to move during labor. Very large doses of anesthetics or analgesics may result in respiratory depression.

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Local anesthetic in the context of Denatonium

Denatonium, usually available as denatonium benzoate (under trade names such as Denatrol, BITTERANT-b, BITTER+PLUS, Bitrex, Bitrix, and Aversion) and as denatonium saccharinate (BITTERANT-s), is the bitterest chemical compound known, with bitterness thresholds of 0.05 ppm for the benzoate and 0.01 ppm for the saccharinate. It was discovered in 1958 during research on local anesthetics by T. & H. Smith of Edinburgh, Scotland, and registered under the trademark Bitrex.

Dilutions of as little as 10 ppm are unbearably bitter to most people. Denatonium salts are usually colorless and odorless solids, but are often traded as solutions. They are used as aversive agents (bitterants) to prevent inappropriate ingestion. Denatonium is used in denatured alcohol, antifreeze, preventive nail biting preparations, respirator mask fit-testing, animal repellents, liquid soaps, shampoos, and Nintendo Switch game cards to prevent accidental swallowing or choking by children. It is not known to pose any long-term health risks.

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Local anesthetic in the context of Pudendal anesthesia

Pudendal anesthesia (pudendal nerve block, pudendal block or saddle block) is a form of local anesthesia. Pudendal anesthesia can be used to diagnose as well as treat illnesses. A nerve block is the use of local anesthetic (e.g lidocaine) to inhibit the sensation of pain caused by one or multiple nerves. A nerve block can help doctors confirm what nerve is causing the pain to support a diagnosis. A nerve block can also be used to prevent pain before a procedure, or relieve chronic pain. The pudendal block gets its name because a local anesthetic, such as lidocaine or chloroprocaine, is injected into the pudendal canal where the pudendal nerve is located. The pudendal nerve branches off of the sacral plexus and is both a sensory and motor nerve. The pudendal nerve provides sensation information (i.e. innervates) for the anal canal, external anal sphincter, and the perineum. Pudendal nerve blocks can be used to provide pain relief to this region for about 30 days, but has been reported to last months in some patients. It is primarily used to provide analgesia during obstetrics procedures such as forceps delivery. It can also be used during anorectal surgery, urologic surgery, diagnosing or treating chronic perineal pain (i.e. pudendal neuralgia), and other gynecologic procedures

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