CRNA : the clinical forum for nurse anesthetists
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The most common local anesthetics in clinical use today are of two classes: amino-esters and amino-amides. These two classes differ not only in their chemical structure but also in regard to their metabolism and allergic potential. ⋯ The effects of local anesthetics are primarily caused by the blockade of the sodium channels, thus affecting the slow and fast depolarization phase of the action potential. With the basic understanding of the chemistry and pharmacology of the different local anesthetic agents, the nurse anesthetist can more effectively integrate the use of these drugs into their clinical practice.
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This article addresses the use of peripheral nerve blocks as a primary or adjunctive technique of anesthesia for selective operative procedures. The use of these blocks can reduce the amount of inhalational and narcotic agents used during an anesthetic and facilitate a pain-free postoperative period.