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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 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: 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: 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...

Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Local Anesthetics: Clinical Application as Spinal Anesthesia

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

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Updated: May 21, 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

Topical anesthesia for intravitreal injection.

Jonathan Gambrell, Shlomit Schaal

Expert Opinion on Drug Delivery

|June 5, 2012

Summary

This summary is machine-generated.

Topical anesthesia before intravitreal injections offers limited pain relief for ocular conditions. Addressing patient concerns is crucial for minimizing discomfort during these common eye treatments.

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Area of Science:

Ophthalmology
Pharmacology

Background:

Intravitreal injections are standard treatment for macular degeneration, diabetic eye disease, and retinal vascular occlusions.
Pain at the injection site is a common patient complaint during intravitreal procedures.
Current topical anesthesia methods do not reliably eliminate pain from intravitreal injections.

Discussion:

Research comparing different topical anesthetic agents has not identified a universally superior option.
The effectiveness of topical anesthetics in completely abolishing pain sensation remains unproven.
Patient anxiety and concerns regarding intravitreal injections significantly impact their experience.

Key Insights:

No single topical anesthetic agent is consistently recommended for routine use to manage intravitreal injection pain.
Minimizing patient pain and anxiety requires a comprehensive approach beyond just topical anesthesia.
Addressing patient-reported concerns is vital for improving the tolerability of intravitreal procedures.

Outlook:

Further research is needed to develop more effective pain management strategies for intravitreal injections.
Investigating novel anesthetic techniques or adjunct therapies may improve patient outcomes.
Focusing on patient-centered care, including psychological support, is essential for enhancing treatment adherence.