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      Topical anesthesia

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          Abstract

          Topical anesthetics are being widely used in numerous medical and surgical sub-specialties such as anesthesia, ophthalmology, otorhinolaryngology, dentistry, urology, and aesthetic surgery. They cause superficial loss of pain sensation after direct application. Their delivery and effectiveness can be enhanced by using free bases; by increasing the drug concentration, lowering the melting point; by using physical and chemical permeation enhancers and lipid delivery vesicles. Various topical anesthetic agents available for use are eutectic mixture of local anesthetics, ELA-max, lidocaine, epinephrine, tetracaine, bupivanor, 4% tetracaine, benzocaine, proparacaine, Betacaine-LA, topicaine, lidoderm, S-caine patch™ and local anesthetic peel. While using them, careful attention must be paid to their pharmacology, area and duration of application, age and weight of the patients and possible side-effects.

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          Most cited references55

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          ASRA practice advisory on local anesthetic systemic toxicity.

          The American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity assimilates and summarizes current knowledge regarding the prevention, diagnosis, and treatment of this potentially fatal complication. It offers evidence-based and/or expert opinion-based recommendations for all physicians and advanced practitioners who routinely administer local anesthetics in potentially toxic doses. The advisory does not address issues related to local anesthetic-related neurotoxicity, allergy, or methemoglobinemia. Recommendations are based primarily on animal and human experimental trials, case series, and case reports. When objective evidence is lacking or incomplete, recommendations are supplemented by expert opinion from the Practice Advisory Panel plus input from other experts, medical specialty groups, and open forum. Specific recommendations are offered for the prevention, diagnosis, and treatment of local anesthetic systemic toxicity.
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            The carrier potential of liposomes in biology and medicine (second of two parts).

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              Methemoglobinemia: A Review and Recommendations for Management

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                Author and article information

                Journal
                J Anaesthesiol Clin Pharmacol
                J Anaesthesiol Clin Pharmacol
                JOACP
                Journal of Anaesthesiology, Clinical Pharmacology
                Medknow Publications & Media Pvt Ltd (India )
                0970-9185
                2231-2730
                Oct-Dec 2015
                : 31
                : 4
                : 450-456
                Affiliations
                [1]Department of Anesthesiology and Intensive Care, Govind Ballabh Pant Hospital, New Delhi, India
                Author notes
                Address for correspondence: Dr. Mritunjay Kumar, N-207, Vivek Vihar, Sector 82, Noida, U.P. - 201304, India. E-mail: dr.mritunjay@ 123456gmail.com
                Article
                JOACP-31-450
                10.4103/0970-9185.169049
                4676230
                26702198
                857ac459-8013-4449-b41f-2dd01f16d260
                Copyright: © Journal of Anaesthesiology Clinical Pharmacology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Review Article

                Anesthesiology & Pain management
                topical anesthesia,eutectic mixture of local anesthetics,iontophoresis,local anesthetic,skin permeation enhancer,sonophoresis,uses and side-effects of topical anesthetics

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