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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...

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 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 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...

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...

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Updated: May 21, 2026

Minimally Invasive Surgical Decompression of Occipital Nerves

Minimally Invasive Surgical Decompression of Occipital Nerves

Published on: September 13, 2024

Topical lidocaine patch 5% for acute postoperative pain control.

D Gilhooly¹, B McGarvey, H O'Mahony

¹Anaesthesia and Pain Management, Sligo General Hospital, Sligo, Ireland. d.gilhooly@excite.com

BMJ Case Reports

|June 21, 2012

Summary

This study explores using 5% lidocaine patches for pain relief after lower segment caesarean sections (LSCS) in patients with severe allergies. Lidocaine patches, combined with transcutaneous electrical nerve stimulation, effectively managed postoperative pain, offering a safe alternative analgesic option.

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Minimally Invasive Surgical Decompression of Occipital Nerves

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Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds

Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds

Published on: October 20, 2012

Area of Science:

Anesthesiology
Obstetrics
Pain Management

Background:

Postoperative pain management after lower segment caesarean section (LSCS) can be challenging, especially in patients with multiple drug allergies.
Conventional analgesics may be contraindicated due to patient history of atopy and anaphylaxis.

Observation:

A patient with a history of anaphylaxis to common analgesics and asthma triggered by aspirin underwent LSCS under spinal anesthesia.
Postoperatively, the patient refused standard oral analgesics due to fear of allergic reactions.

Findings:

Application of three 5% lidocaine patches to the LSCS wound provided significant pain relief, reducing visual analogue scale (VAS) scores from 10/10 to 5/10 at rest and 10/10 to 7/10 with movement.
Adjunctive transcutaneous electrical nerve stimulation (TENS) further improved pain control, reducing VAS scores to 2/10, particularly for associated back pain.

Implications:

Topical 5% lidocaine patches represent a novel, easy-to-apply, and minimally invasive option for managing postoperative LSCS pain.
This method, when used as part of a multimodal analgesic strategy, offers a safe alternative for patients with contraindications to traditional pain medications.