[Specific local anesthesia: pharmacology, administration and clinical use (author's transl)]

In order to achieve an optimal combination of principal and side effects of the various drugs used in local anesthesia, a thorough knowledge of pharmacology, anatomy and physiology is essential. The properties of the most commonly used short-acting (Lidocain) medium (Mepivacain) and long-acting (Bupivacain) local anesthetics are described, as well as the effect of the vasoconstrictors Adrenalin and Ornipressin, and of hyaluronidase. The advantages and drawbacks of the different application modalities are discussed. In clinical practice, the surgeon has to be aware of his particular local anesthetic needs at any given time and any stage of the operation, and should attempt to create ideal conditions by careful selection, combination and application of the different drugs. The choice is relatively easy in operations on the globe, the eye muscles and the lacrimal drainage system. In major lid operations, however, greater differentiation in the selection of drugs and methods of application is advisable.