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Local Anesthetics (Paperback, Softcover reprint of the original 1st ed. 1987)
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Local Anesthetics (Paperback, Softcover reprint of the original 1st ed. 1987)
Series: Handbook of Experimental Pharmacology, 81
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Local anesthetics are among the most widely used drugs. Their
development over the past century ranges from a documented
influence on Freud's Interpretation of Dreams 1 to the synthesis of
the ubiquitously popular lidocaine, as described in Chapter 1. For
surgical procedures the use of regional, epidural and intrathecal
local anesthesia has increased continuously during the past decade.
Local anesthetics are also applied by physicians to ameliorate
unpleasant sensations and reactions to other procedures, such as
tracheal intubation. The presence or the threat of cardiac
arrhythmias is often countered by chronic administration oflocal
anesthetic-like agents, such as lidocaine or procainamide. Relief
of acute pain, accompanying dental manipulations, for example, and
of chronic pain are also accomplished with traditional local
anesthetics. And over-the-counter formula tions of topical local
anesthetics provide practitioners of solar indiscretion welcome
relief from their otherwise unaccommodating sunburn. In all these
applications the final effect of the local anesthetic is an
inhibition of electrical activity, accomplished as a reduction or
total blockade of action potentials. The primary site of action is
the sodium channel, a transmembrane protein which is essential for
the influx of sodium ions that subserves impulse generation and
propagation in nerves, skeletal muscle, and heart. The detailed
mechanisms oflocal anesthetic action are still being investigated
and Chapter 2 of this volume provides a current overview of that
subject."
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