Friday, 30 August 2013

Local Anaesthesia - What You Need to Know

If you ever needed to have a surgery, you surely know what anaesthesia is. The most commonly used drug in hospitals around the globe. The word anaesthesia is derived from a Greek word meaning “loss of sensation”. The term “anaesthesia” was first coined by Oliver W Holmes in the year 1846 to explain insensibility to sensation by means of induced drugs. In a medical procedure, apart from numbing your sensation, anaesthesia is also used to induce other reversible effects on your body like relieving pain, reducing anxiety, causing amnesia to blank out your memory of the procedure or how it felt and paralyzing your muscles. Today anaesthesia can be broadly classified into three categories Local, Regional and General Anaesthesia. In this article, we will briefly discuss the first category Local Anaesthesia and the advantages and disadvantages involved in its use.

Local Anaesthesia
Local Anaesthesia is administered to affect just a small patch of the body. It obstructs the movement of nerve impulses and thus prevents the nerves from carrying pain signals to your brain without affecting the consciousness and sensitivity of other areas of the body. One very common use of Local Anaesthesia can be seen in dental procedures, where Novocaine shots are used to numb the nerves in the mouth. It does not leave the person unconscious. It rather helps in reducing pain and distress. Local Anaesthesia is readily available and can be easily administered.


The many advantages of Local Anaesthesia include;
1.    The patient does not lose consciousness.
2.    The patient is sustained by his own breathing.
3.    The risk of being choked by gastric content is improbable.
4.    Patient recovery is fast and smooth and does not need much skilled attention.
5.    Surgical stress is reduced considerably.
6.    Hospitalization may not be necessary for outpatients.
7.    The anaesthetic action stays for a longer time and provides pain relief even several hours after surgery.
8.    Patient can almost immediately resume normal activity like eating, walking and so on.

The disadvantages of local Anaesthesia include;
1.    Causing lethargy in Patients.
2.    Administration requires practice and skilled person for better results.
3.    In some instances, it may take up to 30 minutes or more for the effect to be seen on patients.
4.    In some cases, it may not even be effective and may require a combination of both General and Local Anaesthesia.
5.    In some cases, if Local Anaesthesia is administered intravenously or an overdose is given there are chances of toxicity.

Cocaine was the first anaesthetic to be discovered and still remains the only naturally produced local anaesthetic. Though used commonly in the 1800’s, the toxic effects of Cocaine were soon identified and this led to the need of developing a much safer means of local anaesthetic. The development of modern organic chemistry resulted in the development of synthetically derived Local Anaesthetics. The decades of growth in the field of science and medicine has seen the evolution of Local Anaesthesia as a more preferred and safer anaesthetic option. The future of Local Anaesthesia is bright with many more efforts and clinical trials being undertaken to make it more effective in various medical procedures.

For more information visit website: http://drandrewsnell.com/.

Thursday, 22 August 2013

The Impact of Intra-Operative Transoesophageal Echocardiography on Cardiac Surgical Practice

The use of transoesophageal echocardiography during cardiac surgery has increased dramatically and it is now widely accepted as a routine monitoring and diagnostic tool. A prospective study was carried out between September 2004 and September 2007, and included all patients in whom intra-operative echocardiography was performed, 2 473 (44%) out of a total of 5 591 cases. Changes to surgery were subdivided into predictable (where echocardiographic examination was planned specifically to guide surgery) and unpredictable (new pathology not diagnosed pre-operatively). A change in the planned surgical procedure was documented in 312 (15%) cases. In 216 (69%) patients the changes were predictable and in 96 (31%) they were unpredictable. The number of predictable changes increased between 2004-5 and 2006-7 (8% vs 13%, p = 0.025). In these cases, intra-operative echocardiography was specifically requested by the surgeon to help determine the operative intervention. This has implications for consent and operative risk, which have yet to be fully determined.

For more information please visit website: http://drandrewsnell.com/.