Neuraxial Pharmacology 2025-Part 1

Video Transcription

Video Summary

This video is part one of a two-part series focused on the pharmacology of local anesthetics used in central neuraxial techniques, with a special emphasis on obstetric anesthesia. The session begins with an exploration of the clinical pharmacology and science behind local anesthetics, which function primarily as sodium channel blockers on nerve tissues. There are nine sodium channel subtypes in the body, grouped into teratotoxin-resistant and susceptible categories, with implications for targeted local anesthetic development. <br /><br />The presentation clarifies how local anesthetics work by penetrating the nerve tissue membrane, where they dissociate into a charged form that blocks sodium channels, affecting the rate of nerve impulse transmission. The roles of pH, ionization, lipid solubility, protein binding, concentration, and volume in determining the onset and duration of action are also explained, with an emphasis on their clinical applications in anesthesia versus analgesia.<br /><br />The video also touches on the unique onset characteristics of different local anesthetics and addresses local anesthetic systemic toxicity, highlighting how rapid increases in plasma concentrations can cause adverse effects. Finally, the session discusses lipid emulsion therapy as a treatment for systemic toxicity. Part two of the series will focus on applying these pharmacological principles clinically.

Keywords

local anesthetics

central neuraxial techniques

obstetric anesthesia

sodium channel blockers

systemic toxicity

lipid emulsion therapy

nerve impulse transmission