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Local Anesthetics: Common Agents and Their Applications

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...

Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...

Local Anesthetics: Pharmacokinetics

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

Local Anesthetics: Differential Sensitivity of Nerve Fibers

Local Anesthetics: Differential Sensitivity of Nerve Fibers

Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...

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Transcutaneous Neuromuscular Electrical Stimulation for Treating Varicocele-Induced Scrotal Pain

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Topical anesthesia with EMLA does not decrease pain during vasectomy.

Anil A Thomas¹, Carvell T Nguyen, Nivedita B Dhar

¹Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

The Journal of Urology

|May 24, 2008

Summary

This summary is machine-generated.

EMLA cream, a topical anesthetic, did not significantly reduce pain during no-scalpel vasectomy. This study found no difference in pain scores between patients who used EMLA and those who did not.

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Utero-tubal Embryo Transfer and Vasectomy in the Mouse Model

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Published on: February 28, 2014

Area of Science:

Urology
Pain Management
Anesthesiology

Background:

Vasectomy is a common surgical procedure for male sterilization.
Pain management during vasectomy is crucial for patient satisfaction.
Previous research on topical anesthetics like EMLA for vasectomy pain has yielded conflicting results.

Purpose of the Study:

To evaluate the efficacy of EMLA (eutectic mixture of local anesthetics) cream in reducing pain during bilateral percutaneous no-scalpel vasectomy.
To compare pain levels in patients receiving EMLA versus no topical anesthesia.

Main Methods:

A prospective study involving 316 patients undergoing percutaneous no-scalpel vasectomy.
Patients were randomized to receive EMLA cream application 1 hour prior to surgery or no topical anesthesia (control group).
All patients received local infiltration anesthesia; pain was assessed using a visual analog scale post-procedure.

Main Results:

No significant difference in mean visual analog scale pain scores was observed between the EMLA group (21.5) and the control group (21.0).
Patient demographics, including mean age, were similar across both groups.
The p-value of 0.8 indicated no statistically significant difference in pain reduction attributed to EMLA.

Conclusions:

Topical anesthesia with EMLA cream does not significantly decrease pain associated with percutaneous no-scalpel vasectomy.
EMLA is not an effective adjunct for pain reduction in this specific vasectomy technique.
Further research may explore alternative pain management strategies for vasectomy.