Local anesthetics are drugs that help numb a specific part of the body so that a person doesn't feel pain during certain medical or dental procedures. Instead of putting someone to sleep like general anesthesia does, local anesthetics just block the pain in one area while the person stays awake and alert. They're often used for small surgeries, stitches, or when fixing a tooth. These medications work by stopping the nerves in that area from sending pain signals to the brain. Because they're fast-acting and pretty safe when used correctly, they’ve become a regular and important part of medical field
Local anaesthetics work by blocking voltage-gated sodium (Na⁺) channels in nerve cell membranes, preventing the initiation and propagation of action potentials that transmit pain signals. The uncharged (unionized) form of the drug crosses the nerve membrane, then inside the neuron, it becomes ionized and binds to the intracellular part of the open sodium channels, stabilizing them in an inactive state. This use-dependent blockade is stronger in frequently firing nerves, effectively inhibiting nerve impulse conduction and thus pain sensation.
1. Lidocaine
Use: Very common in dental procedures, minor surgeries, and skin treatments.
Fun fact: It works quickly and lasts for about 1–2 hours.
2. Bupivacaine
Use: Often used in epidurals (like during childbirth) or longer surgeries.
Lasts much longer than lidocaine—up to several hours.
3. Ropivacain
Use: Similar to bupivacaine but with slightly less risk of heart-related side effects.
Great for nerve blocks and pain relief after surgery.
4. Benzocaine
Use: Found in over-the-counter products like throat sprays, gels for toothaches, or creams for skin irritation.
Works on the surface (topically), not injected.
•Minor surgeries such as skin biopsies, breast biopsies, repairing broken bones, stitching deep cuts, dental surgery, mole or verruca removal, and cataract surgery.
•Procedures where general anesthesia is unnecessary or undesirable, allowing quicker recovery and fewer side effects.
•Regional anesthesia techniques like nerve blocks, epidurals, and spinal anesthesia to numb larger areas for surgeries or pain control, often when the patient needs to stay awake.
•Treatment of localized conditions such as mouth ulcers, sore throats, or long-term joint pain with local anesthetic gels, sprays, or injections.
•Discomfort or pain at the injection site, bruising, bleeding, or soreness
•Tingling, numbness, weakness, or continuing pins and needles sensation
•Dizziness, headaches, blurred vision, muscle twitching, or shivering
•Difficulty urinating or urinary leakage (especially with epidurals)
•Allergic reactions such as redness, itching, hives, swelling, or in rare cases, severe anaphylaxi
•Rare but serious effects include seizures, cardiac arrhythmias, cardiac arrest, and central nervous system toxicity (convulsions, coma, respiratory depression)
•Temporary neurological symptoms or nerve damage, usually resolving over time
Seizures
Headaches
Dizziness
Inform your doctor about all medications you take, especially blood thinners like aspirin, warfarin, clopidogrel, and herbal supplements such as fish oil or turmeric, as these increase bleeding risk at the injection site.
• Avoid alcohol for at least 24 hours before receiving local anesthesia.
• Follow fasting instructions before the procedure, typically no eating or drinking for several hours.
• The injection site should be properly disinfected, and the procedure performed by trained professionals in a setting equipped with resuscitation equipment and monitoring to manage rare systemic toxicity.
• Use the lowest effective dose and aspirate before injection to avoid intravascular administration.
• Patients should move carefully until numbness wears off to prevent injury.
• Monitor vital signs during administration, especially when large doses are used.
*Contraindications:
• Known allergy to the local anesthetic agent or any ingredient in the anesthetic solution is an absolute contraindication
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