The pharmacology of local anesthetics

Understanding of the pharmacology of local anesthesia is important for selection of a local anesthetic for use in equine standing surgery. In general, the action potential is inhibited by local anesthetics by preventing the influx of sodium ions across the axonal membrane. The physicochemical properties of each local anesthetic determine the onset of action, potency, and duration of action. Procaine, chlorprocaine, lidocaine, and mepivacaine are the local anesthetics still used clinically in horses; lidocaine is the most widely used. The future of equine local anesthesia may see the introduction of longer acting, more potent drugs currently used clinically in humans and dogs as well as drugs not classified as local anesthetics--alpha-2 agonists and opioids--for use in epidural anesthesia.