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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 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...

Angle Closure Glaucoma: Treatment

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...

Ophthalmic Drug Delivery Systems

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Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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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...

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Related Experiment Video

Updated: Jun 26, 2026

Intracameral Injection in Rats with Low Risk of Adverse Effects

Intracameral Injection in Rats with Low Risk of Adverse Effects

Published on: May 31, 2024

Retrobulbar versus topical anesthesia for phacoemulsification.

M R Fazel¹, Z Forghani, D Aghadoost

¹Department of Anesthesiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Pakistan Journal of Biological Sciences : PJBS

|January 14, 2009

Summary

Phacoemulsification cataract surgery can be safely performed using topical anesthesia with comparable pain and complication rates to retrobulbar anesthesia. Both methods offer effective pain management and procedural feasibility for patients undergoing eye surgery.

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Ocular Therapeutic Delivery and Advanced Tissue Retrieval in Adult Rats

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Intracameral Injection in Rats with Low Risk of Adverse Effects

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Ocular Therapeutic Delivery and Advanced Tissue Retrieval in Adult Rats

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Published on: May 23, 2025

Area of Science:

Ophthalmology
Anesthesiology

Background:

Cataract surgery is a common procedure.
Anesthesia choice impacts patient outcomes and safety.
Topical and retrobulbar anesthesia are common techniques for phacoemulsification.

Purpose of the Study:

To compare intraoperative pain, perioperative complications, and hemodynamic changes between topical and retrobulbar anesthesia during phacoemulsification.
To evaluate the safety and efficacy of topical anesthesia for cataract surgery.

Main Methods:

A randomized study of 564 patients undergoing phacoemulsification.
Patients received either topical anesthesia (tetracaine drops, intracamerally lidocaine) or retrobulbar anesthesia (lidocaine injection).
Pain, complications, and hemodynamic parameters were recorded and compared.

Main Results:

No statistically significant differences in pain scores, visual acuity, or phaco time between groups.
Complications like chemosis and hematoma occurred only in the retrobulbar group.
Hemodynamic parameters remained stable in both groups.

Conclusions:

Topical anesthesia is a safe and effective alternative to retrobulbar anesthesia for phacoemulsification.
Cataract surgery can be performed with topical anesthesia without compromising safety or patient comfort.
Topical anesthesia may reduce certain perioperative complications associated with retrobulbar blocks.