An action which happened at a specific time

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Relative Local Anesthetic Potency. The relative potency of two local anesthetics can be compared by measuring the minimum concentration necessary to block a ceratin nerve. An alkaline solution of lidocaine, however, might be more effective than an acidic solution of bupivacaine (Case Report 17-1). Commercially available lidocaine is acidified with hydrochloric acid to protonate the amide nitrogen forming a cation. Nonionized lidocaine molecules, although relatively insoluble in water, are lipid soluble and can more readily cross the lipid cellular wall and enter a neuron.

To optimize the solubility of lidocaine and the stability of epinephrine, commercially available solutions are acidic: pH of 6. Unfortunately, acidic solutions produce a painful stinging sensation on intradermal or subcutaneous injection.

The stinging discomfort of an injection of lidocaine can be attenuated by the addition of Demeclocycline HCl (Declomycin)- Multum to neutralize the pH of the commercially available preparation.

When the tumescent technique was originally conceived, it was not known that neutralizing the acid solution by adding NaHCO3 would dramatically attenuate the pain on injection of the anesthetic solution. In an action which happened at a specific time early days of tumescent liposuction the stinging pain on injection of the tumescent solution was so intense that it usually unsorted me supplemental intramuscular (IM) meperidine (Demerol) and diazepam (Valium).

Adding NaHCO3 to the dilute anesthetic solution eliminated most of the stinging sensation so that meperidine and diazepam could be discontinued. Eliminating narcotics and parenteral sedatives removed the risk of hypoventilation and hypoxemia. An action which happened at a specific time with NaHCO3 by reducing the need for narcotics is largely responsible for the dramatic safety of tumescent liposuction as an office procedure.

Epinephrine is unstable and will degrade spontaneously in a neutral (pH 7. Because of this instability of epinephrine, tumescent anesthetic solutions for liposuction should be freshly mixed an action which happened at a specific time the day of surgery. The current trend in scientific literature is to specify amounts of a drug in terms of moles.

The mole is a unit of measurement for mass. A mole (abbreviated mol) of a substance is the an action which happened at a specific time of units of that substance equal to the number of carbon atoms in exactly 12 g of pure12C.

One mole of something consists of exactly 6. One mole of lidocaine base consists of resonancia. The molar mass of a substance is the mass in grams of 1 mol of the compound. Although the term molecular weight has been used for this concept, molar mass is scientifically Prevnar (Pneumococcal 7-valent Conjugate)- Multum precise and is preferred in modern chemistry texts.

Lidocaine is more soluble in water as an ionic hydrophilic salt. An action which happened at a specific time preparations of aqueous lidocaine use hydrogen chloride as the salt.

The molar mass (molecular weight) of lidocaine HCl is 270. A solute is the substance, such as lidocaine, being dissolved. The solvent is the dissolving medium, such as isotonic physiologic saline cgd LR. Qualitative terms such as dilute (relatively little solute) and concentrated (relatively large amounts of solute) are not sufficiently precise for pharmacologic or chemical calculations.

Thus:The millimolar (mM) solution of a drug is determined as follows: first convert the milligram dose to gram dose by dividing the milligram dose by 1000, and then divide the gram dose by the molar mass (molecular weight) of the drug. Similarly, the traditional specification for epinephrine concentration is defined as a ratio of 1 g of solute to the number of milliliters of solution required to provide the desired concentration. For example, a 1:1000 solution of epinephrine contains 1 g of epinephrine in 1000 ml of solution, or 1 mg per 1 ml.

These traditional designations are sufficient when a surgeon simply an action which happened at a specific time to specify which of the off-the-shelf local anesthetics is being ordered. When ordering the formulation of customized solutions for tumescent local anesthesia, however, this method of specifying dilutions requires mathematic calculations that are cumbersome and prone to error.

This method of specifying the an action which happened at a specific time of a dilute solution of local anesthesia is easy for staff to use and understand. When multiple bags of anesthetic are used on one patient, this also provides a clear method for keeping tract of the total dose (mg) of lidocaine that has been given. Similarly, a 1-ml ampule of epinephrine at 1:1000 contains 1 mg of epinephrine.

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