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Spinal Procedure Injectables

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Pain Management and Palliative Care

Abstract

Injection medication is intended to provide the clinician with an overview of common injectable medication classes used in the clinical setting. Its purpose is to introduce the clinician to major mechanisms of action, chemical structure, clinical effect, and select precautions/contraindications of local anesthetics and corticosteroids.

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Abbreviations

AP:

Action potential

GABA:

Gamma aminobutyric acid

References

  1. Nau C, Wang GK. Interactions of local anesthetics with voltage-gated Na+ channels. J Membr Biol. 2004;201(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  2. Liu SS. Local anesthetics: clinical aspects. In: Benzon H, Raja S, Molloy R, Liu S, Fishman S, editors. Essentials of pain medicine and regional anesthesia. 2nd ed. Philadelphia: Elsevier Science; 2005. p. 558–65.

    Chapter  Google Scholar 

  3. Raymond SA. Subblocking concentrations of local anesthetics: effects on impulse generation and conduction in single myelinated sciatic nerve axons in frog. Anesth Analg. 1992;75(6):906–21.

    Article  CAS  PubMed  Google Scholar 

  4. Gokin A, Strichartz G. Local anesthetics acting on the spinal cord. Access, distribution, pharmacology and toxicology. In: Yaksh TL, editor. Spinal drug delivery: anatomy, kinetics and toxicology. 1st ed. New York: Elsevier; 1999. p. 477–501.

    Google Scholar 

  5. Sitzman B, Chen Y, Clemans R, Fishman S, Benzon H. Pharmacology for the interventional pain physician. In: Benzon H, Raja S, Molloy R, Liu S, Fishman S, editors. Essentials of pain medicine and regional anesthesia. 2nd ed. Philadelphia: Elsevier; 2005. p. 166–80.

    Chapter  Google Scholar 

  6. Butterworth IV JF, Strichartz GR. Molecular mechanisms of local anesthesia: a review. Anesthesiology. 1990;72:711–34.

    Article  CAS  PubMed  Google Scholar 

  7. Cox B, Durieux ME, Marcus MA. Toxicity of local anaesthetics. Best Pract Res Clin Anaesthesiol. 2003;17(1):111–36.

    Article  CAS  PubMed  Google Scholar 

  8. Holmdahl MH. Xylocain (lidocaine, lignocaine), its discovery and Gordh’s contribution to its clinical use. Acta Anaesthesiol Scand Suppl. 1998;113:8–12.

    Article  CAS  PubMed  Google Scholar 

  9. Krunic AL, Wang LC, Soltani K, Weitzul S, Taylor RS. Digital anesthesia with epinephrine: an old myth revisited. J Am Acad Dermatol. 2004;51(5):755–9.

    Article  PubMed  Google Scholar 

  10. MacMahon P, Eustace S, Kavanagh E. Injectable corticosteroid and local anesthetic preparations: a review for radiologists. Radiology. 2009;25(3):647–67.

    Article  Google Scholar 

  11. McAllister R, McDavid A, Meyer T, Bittenbinder T. Recurrent persistent hiccups after epidural steroid injection and analgesia with bupivacaine. Anesth Analg. 2013;116(2):1834–6.

    Google Scholar 

  12. Liu PL, Feldman HS, Giasi R, Patterson MK, Covino BG. Comparative CNS toxicity of lidocaine, bupivacaine, and tetracaine in awake dogs following rapid intravenous administration. Anesth Analg. 1983;62(4):375–9.

    Article  CAS  PubMed  Google Scholar 

  13. Groban L. Central nervous system and cardiac effects from long-acting amide local anesthetic toxicity in the intact animal model. Reg Anesth Pain Med. 2003;28(1):3–11.

    Article  CAS  PubMed  Google Scholar 

  14. Gristwood RW. Cardiac and CNS toxicity of levobupivacaine: strengths of evidence for advantage over bupivacaine. Drug Saf. 2002;25(3):153–63.

    Article  CAS  PubMed  Google Scholar 

  15. Leone S, Di Cianni S, Casati A, Fanelli G. Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine. Acta Biomed. 2008;79(2):92–105.

    CAS  PubMed  Google Scholar 

  16. Brun A. Effect of procaine, carbocain and xylocaine on cutaneous muscle in rabbits and mice. Acta Anaesthesiol Scand. 1959;3(2):59–73.

    Article  CAS  PubMed  Google Scholar 

  17. Hogan Q, Dotson R, Erickson S, Kettler R, Hogan K. Local anesthetic myotoxicity: a case and review. Anesthesiology. 1994;80(4):942–7.

    Article  CAS  PubMed  Google Scholar 

  18. Foster AH, Carlson BM. Myotoxicity of local anesthetics and regeneration of the damaged muscle fibers. Anesth Analg. 1980;59(10):727–36.

    Article  CAS  PubMed  Google Scholar 

  19. Benoit PW, Belt WD. Destruction and regeneration of skeletal muscle after treatment with a local anaesthetic, bupivacaine (Marcaine). J Anat. 1970;107(Pt 3):547–56.

    PubMed Central  CAS  PubMed  Google Scholar 

  20. Yagiela JA, Benoit PW, Buoncristiani RD, Peters MP, Fort NF. Comparison of myotoxic effects of lidocaine with epinephrine in rats and humans. Anesth Analg. 1981;60(7):471–80.

    Article  CAS  PubMed  Google Scholar 

  21. Chu CR, Izzo NJ, Coyle CH, Papas NE, Logar A. The in vitro effects of bupivacaine on articular chondrocytes. J Bone Joint Surg Br. 2008;90(6):814–20.

    Article  CAS  PubMed  Google Scholar 

  22. Piper SL, Kim HT. Comparison of ropivacaine and bupivacaine toxicity in human articular chondrocytes. J Bone Joint Surg Am. 2008;90(5):986–91.

    Article  PubMed  Google Scholar 

  23. Dragoo JL, Korotkova T, Kanwar R, Wood B. The effect of local anesthetics administered via pain pump on chondrocyte viability. Am J Sports Med. 2008;36(8):1484–8.

    Article  PubMed  Google Scholar 

  24. Thumboo J, O'Duffy JD. A prospective study of the safety of joint and soft tissue aspirations and injections in patients taking warfarin sodium. Arthritis Rheum. 1998;41(4):736–9.

    Article  CAS  PubMed  Google Scholar 

  25. Goulet JP, Pérusse R, Turcotte JY. Contraindications to vasoconstrictors in dentistry: Part III. Pharmacologic interactions. Oral Surg Oral Med Oral Pathol. 1992;74(5):692–7.

    Article  CAS  PubMed  Google Scholar 

  26. Karaoglu S, Dogru K, Kabak S, Inan M, Halici M. Effects of epinephrine in local anesthetic mixtures on hemodynamics and view quality during knee arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2002;10(4):226–8.

    Article  PubMed  Google Scholar 

  27. Saunders S, Longworth S. The drugs. In: Injection techniques in orthopaedic and sports medicine: a practical manual for doctors and physiotherapists. 3rd ed. Philadelphia: Churchhill Livingstone/Elsevier; 2006.

    Google Scholar 

  28. Sitzman BT. Pharmacology for the spine injectionist. In: Fenton D, Czervionke L, editors. Image-guided spine intervention. Philadelphia: Saunders Elsevier; 2003.

    Google Scholar 

  29. Devor M, Govrin-Lippman R, Raber P. Corticosteroids suppress ectopic neural discharge originating in experimental neuromas. Pain. 1985;22:127–37.

    Article  CAS  PubMed  Google Scholar 

  30. Stitik T, Kumar A, Kim J, Tran J, Lee C. Chapter 2: pharmacotherapy of joint and soft tissue injections. In: Stitik P, editor. Injection procedures: osteoarthritis and related conditions. New York: Springer; 2010.

    Google Scholar 

  31. Collighan N, Gupta S. Epidural steroids. Cont Educ Anaesth Crit Care Pain. 2010;10(1):1–5.

    Article  Google Scholar 

  32. Catalano III LW, Glickel SZ, Barron OA, Harrison R, Marshall A, Purcelli-Lafer M. Effect of local corticosteroid injection of the hand and wrist on blood glucose in patients with diabetes mellitus. Orthopedics. 2012;35(12):e1754–8.

    Article  PubMed  Google Scholar 

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Correspondence to SriKrishna Chandran M.D. .

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Chandran, S., Kieu, P. (2015). Spinal Procedure Injectables. In: Sackheim, K. (eds) Pain Management and Palliative Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2462-2_37

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  • DOI: https://doi.org/10.1007/978-1-4939-2462-2_37

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2461-5

  • Online ISBN: 978-1-4939-2462-2

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