Draft:Anaesthetic Block

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OLE2109 480464053 - Bill Vasilis Nicolis Draft Proposal (25%)

Anaesthetic block[edit]

Anaesthetic block is performed by qualified personnel by injecting anaesthesia close to a nerve trunk or peripheral nerve group in order to disturb the flow of impulses perceived by the brain, relieving pain temporarily. Anaesthetic block is usually a short-term block of the peripheral nerves usually performed by injecting anaesthesia very close to a nerve group which assists greatly with pain relief. The body begins to feel numb and pain is ultimately eliminated which is the ultimate goal. Pain is blocked out by blocking the flow of pain motions from in and around the area being operated on. This has become widely used in medical practice as it allows for quick and monitored anaesthetic care, rather than general anaesthesia which usually leaves the patient in much more pain after the surgery.[1]


Types of anaesthetic block[edit]

Both less volatile and volatile anaesthetic blocks have been used in medical practice. Below outline a few of the various anaesthetic blocks that are in practice:

Less volatile Anaesthetic Blocks[edit]

Enflurane compound

Enflurane[edit]

Throughout the 1970's and 1980's this was a common type of inhalational anaesthesia used generally for pregnancies. Enflurane is a structural isomer of isoflurane, which is an extremely stable inhalation which allows for rapid adjustments of anaesthesia with minimal change in heart rate. [2]Enflurane is now considered to be less commonly used in medical practice, slightly more volatile anaesthetics are generally considered to be more applicable in today’s medical industry.


Methoxyflurane[edit]

Methoxyflurane compound

Methoxyflurane is also an inhaled anaesthetic block which is most effective when consumed and administered appropriately to alleviate pain following trauma. Methoxyflurane is quite a strong anaesthetic and should not be administered without using nitrous oxide to minimise the strength of the anesthesia.[3] Methoxyflurane decreased the transmission of pain signals by decreasing the junction mediated cell-cell coupling and manipulating the activities of the underlying channels that create action.[4]



Volatile Anaesthetic Blocks[edit]

Desflurance[edit]

Desflurane compound

Desflurane is a volatile Anaesthetic block that is mainly used for general anaesthesia but is now becoming more commonly used for anaesthetic nerve blocks. Desflurane is a methyl ethyl used within the medical industry as an anaesthetic.[5] As it is volatile Desflurane has the potential and capacity to activate GABA channels which have the potential to prevent neurotransmitters and suppress glutamate channels. Desflurane allows for muscle relaxation and reduces pain severity and sensitivity by manipulating tissue excitability, it also decreases the extent of gap junction cell-cell coupling by altering the channels that underlie.[6]




Isoflurane[edit]

Isoflurane compound

Isoflurane is a non-explosive inhalation anaesthetic that generally when administered properly is free from side effects. It is commonly used in practice and is generally considered a popular anaesthetic block used in industry practice.[7] Isoflurane is a binder to the GABA receptor which activates the potassium channel and binds the glutamate receptor a long with the glycine receptor. In addition, it also allows for the decreasing gap junction mediated cell-cell coupling that allows the transmission of pain signals to not be registered. [8] Now, Isoflurane is considered to be one of the most popular anaesthetics administered to patients in order to block any pain and allowing the surgeon to work on the targeted area. As it is generally an inhalation anaesthetic, side effects are minimal.



Factors affecting anaesthetic Block[edit]

Anaesthetic block has become widely used within the medical industry and technology is heightening at a rapid pace. However, anaesthetic block has implications that must be considered before administration of the drug. Many factors can affect the results of anaesthetic block including operator factors, patient factors and procedural factors.

Operator factors can include highly pressurised work environment which can affect the quality of the procedure. Moving on, fatigue and change in staff and procedure can also cause many issues whilst performing the surgery. Poor recording and poor communication between staff can hinder the effectiveness of how the procedure has been carried out which ultimately effects the end result of the anaesthetic block.[9]

Furthermore, patient factors are another critical component in which implications can take place when administering anaesthetic block. Patient factors can include abnormal anatomy of the individual, multiple administration of anaesthetic blocks needed by the same patient, therefore increasing the chance of negative effects after the surgery. Moreover, haemodynamic instability can cause pressures for both the patient and the medical staff performing the operation. Other communication and language factors can lead to negative factors affecting anaesthetic block; however, these can be avoided relatively easier, in comparison to physical factors.[9]

Another potential factor that can hinder the effects of anaesthetic block include procedural factors. These factors stem from potential negative events occurring when surgery is conducted. The potential for a patient moving from the original position can cause for the anaesthetic block to be administered incorrectly leading to severe pain and the potential for the drug to not work as intended. Surgeons must mark the area where anaesthetic block will be induced and this can cause great harm to the patient if not correctly marked, therefore, wrong areas marked can be another potential procedural factor that can hinder the appropriate outcome of using anaesthetic block. Moreover, factors that can be impeded include distractions such as alarms, concentration of staff, phone calls and other various distractions. It is critical and logical that before administering anaesthetic block to a local peripheral nerve group that surgeons 'stop before they block' in order to reduce the failure of wrong-site blocks and the incorrect use of the drug.[9]

Applications of anaesthetic block[edit]

This section will cover the various applications of anaesthetic block and how they have improved as well as the types currently available and in use by medical practitioners. This would be classified as an important subheading as anaesthetic block has several uses within the medical industry.





References[edit]

  1. ^ "Regional Anesthesia, Nerve Blocks | UC San Diego Health". UC Health - UC San Diego. Retrieved 2019-05-05.
  2. ^ "Enflurane". www.drugbank.ca. Retrieved 2019-05-05.
  3. ^ "Methoxyflurane". www.drugbank.ca. Retrieved 2019-05-05.
  4. ^ Moody, Eric J.; Skolnick, Phil (January 1988). "The imidazobenzodiazepine Ro 15-4513 antagonizes methoxyflurane anesthesia". Life Sciences. 43 (16): 1269–1276. doi:10.1016/0024-3205(88)90581-4. ISSN 0024-3205. PMID 2845216.
  5. ^ "Desflurane". www.drugbank.ca. Retrieved 2019-05-05.
  6. ^ Stéfani, Kelly Cristina; Ferreira, Gabriel Ferraz; Pereira Filho, Miguel Viana (February 2018). "Postoperative Analgesia Using Peripheral Anesthetic Block of the Foot and Ankle". Foot & Ankle International. 39 (2): 196–200. doi:10.1177/1071100717739670. ISSN 1071-1007. PMID 29160101.
  7. ^ "Isoflurane". www.drugbank.ca. Retrieved 2019-05-05.
  8. ^ "Isoflurane". www.drugbank.ca. Retrieved 2019-05-05.
  9. ^ a b c Pandit, J. J.; Matthews, J.; Pandit, M. (February 2017). ""Mock before you block": an in-built action-check to prevent wrong-side anaesthetic nerve blocks". Anaesthesia. 72 (2): 150–155. doi:10.1111/anae.13664. PMID 27714767.