Labour analgesia: choice of local anaesthetics

2016 ◽  
Author(s):  
Giorgio Capogna
Keyword(s):  
Local Anaesthetic ◽  
Local Anaesthetics ◽  
Labour Analgesia ◽  
Anaesthetic Potency ◽  
Overall Effectiveness ◽  
Anaesthetic Concentration

In this chapter, the rationale for the choice of commonly used local anaesthetics—racemic bupivacaine, ropivacaine, and levobupivacaine—is reviewed, particularly with respect to their potency and differential block. Epidural and spinal dosing for labour analgesia and the role of ‘up–down’ studies to determine the minimum local anaesthetic concentration (MLAC) for labour analgesia is explained. Applying the MLAC model has enabled clinical comparisons at equipotent concentrations and doses. It has also quantified what contribution opioids have on the overall effectiveness of the analgesic mixture, provided a means of optimizing combinations of local anaesthetic–opioid solutions, examined the effect of inter-individual and obstetric variables on local anaesthetic potency, and provided a pharmacological-based rationale for analgesia solutions used for labour analgesia.

Ab initio SCF study of the effect of Na+ and K+ ions and water on the local anaesthetic-phospholipid interaction

1989 ◽  
Vol 54 (4) ◽  
pp. 862-867 ◽  
Author(s):  
Milan Remko
Keyword(s):  
Hydrogen Bonds ◽  
Ab Initio ◽  
Molecular Orbital ◽  
Local Anaesthetic ◽  
Local Anaesthetics ◽  
Molecular Orbital Calculations ◽  
Model Substances ◽  
Insight Into ◽  
Gaining Insight

For gaining insight into the interactions of local anaesthetics with phospholipids, ab initio molecular orbital calculations were performed using trimethylamine and phosphate as model substances. The (OH)2OPO-···H+N(CH3)3 interaction was found comparable in strength to the (OH)2OPO-···M+ (M = Na, K) interaction and considerably stronger than the (OH)2OMPO···H2O interaction. This suggests that a major role of local anaesthetics may consist in their disturbing the P-O···H2O hydrogen bonds. Such interference may be one of the possible types of interaction between local anaesthetics and the biophase, leading to a measurable pharmacological effect.

scholarly journals The effect of butacaine on adenine nucleotide binding and translocation in rat liver mitochondria

1975 ◽  
Vol 148 (3) ◽  
pp. 527-531 ◽  
Author(s):  
D R Fayle ◽  
G J Barritt ◽  
F L Bygrave
Keyword(s):  
Rat Liver ◽  
Local Anaesthetic ◽  
Binding Sites ◽  
Adenine Nucleotide ◽  
Adenine Nucleotides ◽  
Nucleotide Binding ◽  
Local Anaesthetics ◽  
Liver Mitochondria ◽  
Rat Liver Mitochondria ◽  
Mitochondrial Inner Membrane

The effect of the local anaesthetic, butacaine, on adenine nucleotide binding and translocation in rat liver mitochondria partially depleted of their adenine nucleotide content was investigated. The range of butacaine concentrations that inhibit adenine nucleotide translocation and the extent of the inhibition are similar to the values obtained for native mitochondria. Butacaine does not alter either the total number of atractyloside-sensitive binding sites of depleted mitochondria, or the affinity of these sites for ADP or ATP under conditions where a partial inhibition of the rate of adenine nucleotide translocation is observed. The data are consistent with an effect of butacaine on the process by which adenine nucleotides are transported across the mitochondrial inner membrane rather than on the binding of adenine nucleotides to sites on the adenine nucleotide carrier. The results are briefly discussed in relation to the use of local anaesthetics in investigations of the mechanism of adenine nucleotide translocation.

Local anaesthetics: Theoretical aspects

2021 ◽  
pp. 175573802110351
Author(s):  
Gareth Allen ◽  
Rebecca Butler
Keyword(s):  
Primary Care ◽  
Adverse Effects ◽  
Surgical Procedures ◽  
Local Anaesthetic ◽  
Secondary Care ◽  
Local Anaesthetics ◽  
Clinical Use ◽  
Minor Surgical Procedures ◽  
Nervous Conduction

Local anaesthetics are frequently used in both primary and secondary care. These agents transiently reduce the nervous conduction of nociceptive signals, reducing sensations of pain. In primary care, local anaesthetics are often used for minor surgical procedures. However, there are other uses for these agents. It is important to understand the issues encountered when using local anaesthetics in primary care. This review will cover clinical use, relevant pharmacology and adverse effects of the different local anaesthetic preparations.

Increasing the impact of SHRM on organizational performance

2019 ◽  
Vol 27 (5) ◽  
pp. 7-8
Keyword(s):  
Firm Performance ◽  
Organizational Performance ◽  
Design Methodology ◽  
Reading Time ◽  
Content Type ◽  
Pertinent Information ◽  
The Impact ◽  
Practical Implications ◽  
Overall Effectiveness

Purpose This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies. Design/methodology/approach This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context. Findings The role of HRM is increasingly being viewed in strategic as well as functional terms. The impact of SHRM on firm performance is also determined by factors in its internal and external contexts. Balance between these contextual dimensions and input from various actors in the organization can help increase the overall effectiveness of a SHRM system. Originality/value The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

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