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Chapter 1. The History of Local Anesthesia
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In 1653, the first person to describe the anesthetic effects of coca was:
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B is correct. Bernabé Cobo, who spent his life bringing Christianity to the Incas, was the first to describe the anesthetic effects of coca.
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The local anesthetic properties of cocaine were first appreciated, in 1884, for the treatment of:
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D is correct. Carl Koller performed the first ophthalmologic surgical procedure using local anesthesia on a patient with glaucoma.
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An important advancement in local anesthetic drugs was due to the introduction of:
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A. Prilocaine, as it is metabolized to end products that are nontoxic
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B. Lidocaine, as it is an amide local anesthetic with lower side effects
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C. Ropivacaine, as the racemic mixture reduces the risk of cardiac toxicity
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D. Procaine, as there are fewer allergic reactions than tetracaine
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B is correct. Lidocaine is an amino amide derivative, a stable compound not influenced by exposure to high temperatures, and, most importantly, one that does not have the allergic potential of the ester-type local anesthetics. The metabolite of prilocaine is implicated in methemoglobinemia. Ropivacaine is an S-enantiomer formulation. Procaine has the same allergic potential as tetracaine; both are ester anesthetics.
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Tumescent anesthesia refers to:
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A. Intraneural injections of local anesthetics into peripheral nerves causing swelling and conduction block
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B. Use of large volumes of dilute local anesthetic solutions for cutaneous procedures
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C. Cutaneous infiltration of physiologic sterile water and local anesthetic solutions to effect conduction block
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D. Large volumes of a dilute solution of 2% cocaine with physiologic sterile saline for cutaneous procedures
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B is correct. Karl Ludwig Schleich’s approach still seems to be relevant, particularly with the recent European enthusiasm for tumescent anesthesia, in which sometimes-huge volumes of very dilute local anesthetic are used for surface surgery.
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The first successful and ...