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What Is Local Anesthesia?

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JCole View Drop Down
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    Posted: 01 Sep 2009 at 10:12am
What Is Local Anesthesia?

Local anesthesia is commonly used for a variety of relatively minor procedures, such as dentistry, sewing up wounds in the emergency room, and operations on the toes and fingers and other superficial areas of the body. Local anesthesia is less complicated and often safer than general anesthesia because it involves fewer drugs and has less effect on blood pressure, heart rate, and breathing because there is no loss of consciousness. In dental procedures, local anesthesia is advantageous because protective reflexes such as the gag reflex, which helps prevent choking, remain intact.

Local anesthetics are most commonly administered by injecting them into the part of the body that needs to be anesthetized. They can be injected directly into the tissue being operated on, a technique known as local infiltration. Or, they can be injected near the nerves that carry pain impulses from a particular part of the body, a technique known as nerve block. Topical anesthesia is the application of a local anesthetic directly onto the surface of a mucous membrane, such as the eye or the lining of the throat or nose.

Regional anesthesia is produced by injecting a local anesthetic around the spinal area, thus anesthetizing a larger area of the body than in local anesthesia. Spinal anesthesia is a type of regional anesthesia in which the anesthetic is injected into the fluid around the spinal cord. Epidural anesthesia is a similar technique, but the anesthetic is injected into the spinal canal between the membranes that surround the spinal cord. Spinal and epidural anesthesia block sensation everywhere in the body that is lower than the site of injection. These techniques are frequently used in childbirth and in surgery on the lower half of the body, such as prostate gland removal and surgery on the hips or knees.

The earliest known local anesthetic was cocaine, but it is rarely used today because it can cause convulsions and nervousness, and it is addictive. The most commonly used local anesthetic today is lidocaine. Procaine, more commonly known by its brand name Novocain, is sometimes used as a local anesthetic, particularly in dental procedures. However, it does not last as long as lidocaine, and it is more toxic. Bupivacaine is a very long acting local anesthetic that is useful for long operations and provides a greater duration of pain relief after surgery. To help allay patients’ anxiety, a sedative is often given as a part of local anesthesia.

All local anesthetics can be toxic if injected in too high a dose. Particularly when used as part of spinal or epidural anesthesia, local anesthetics may cause a dangerous fall in blood pressure. Many people experience nervousness and discomfort when local anesthetics are injected with epinephrine, a drug that constricts blood vessels to help keep the anesthetic in the area where it is needed. However, true allergic reactions to local anesthetics are very rare.           

Contributed By:
Monica Winefryde Furlong, M.B., Ch.B., M.D.
Attending Anesthesiologist, Beth Israel Medical Center
North, New York, NY. Author of Going Under: Preparing
Yourself for Anesthesia.

"Anesthesia," Microsoft® Encarta® Online Encyclopedia 2009 © 1997-2009 Microsoft Corporation. All Rights Reserved.
© 1993-2009 Microsoft Corporation. All Rights Reserved.

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Edited by JCole - 01 Sep 2009 at 10:13am
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