General side effects
Overall, regional anesthesiaLocal anesthesia is considered to be very safe with few side effects, since it usually does not cause systemic reactions. However, if the anaesthetic is accidentally injected into veins or arteries, this can lead to extreme circulatory problems, as the anaesthetics also inhibit the transmission of nerve signals in the heart and brain. What could also interest you: Complications in anesthesiaAnesthesia can be divided into different stages of intoxication (poisoning) or side effects.
In order to avoid this maximum complication at all costs, local anesthetics can be given in small trial doses in difficult cases first to confirm a correct position. In addition, ultrasound or nerve stimulation should be used to secure the position. Since the patient is awake and responsive during local anesthesia, it is important to pay close attention to the patient.
Thus, even if the patient reports a strange sensation or metallic taste in the mouth, it is possible to react in order to avoid worse complications. The most important measure in the event of such complications is to safeguard vital functions. This includes oxygenation and, if the brain is involved, intubation to secure the airways.
- The prodromal stage is characterized by a perioral numbness (i.e. around the mouth) and a metallic taste in the mouth.
- The pre-convulsive stage leads to tremor, tinnitus, nystagmus and somnolence.
- In the following phase, the convulsive stage, there are distinct central reactions with tonic-clonic seizures.
- In the last phase, there is a significant decompensation of the brain with coma, respiratory arrest and circulatory collapse.
Local anesthetics act at the cellular level by blocking certain ion channels. In this way, they impede the transmission of excitation from one cell to another and thus also the transmission of pain sensation. If too high a concentration of local anesthetics reaches the circulatory system, it can also block the excitation conduction in the heart and thus trigger life-threatening cardiac arrhythmia.
Since local anesthetics are usually applied superficially or near the spinal cord, this side effect occurs only very rarely. In addition to surgical procedures, local anesthetics are also used in pain therapy, for example after an arthroscopic procedure on the shoulder or knee. According to a study, there is a risk of damage to the hyaline cartilage, especially when using a pain pump, which continuously pumps painkillers into the joint.
In particular, the local anesthetic bupivacaine leads to dissolution of the cartilage (chondrolysis). This can lead to complaints such as joint pain, restricted mobility and stiffness of the joints. Which could also be of interest to you: Cartilage damage
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