Hong Kong Med J 2002;8:106-13 | Number 2, April 2002
Local anaesthesia outside the operating room
SK Chan, MK Karmakar, PT Chui
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
An increasing number of minor surgical procedures are performed under local anaesthesia in clinical settings outside the operating room, where monitoring and resuscitation equipment—as well as personnel skilled in resuscitation—may not be readily available. Serious adverse effects and even fatalities may result from the use of local anaesthetic agents, arising from a variety of causes such as systemic toxicity, allergy, vasovagal syncope, and reaction to additives present in the local anaesthetic. This article briefly reviews the pharmacology of local anaesthetic agents, and describes various techniques commonly used for local anaesthesia, with special emphasis on safety. Clinical features of toxicity, and its differential diagnosis and management, are also discussed.
Key words: Ambulatory surgical procedures; Anesthetics, local; Drug toxicity; Pharmacology; Safety
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