Understanding Local Analgesia and Anesthesia: Types and Mechanisms Explained

Local analgesia and anesthesia involve desensitizing a specific area of the body through various methods such as surface analgesia, nerve blocks, and regional analgesia. These techniques rely on either ester-linked or amide-linked compounds with different potencies and durations of action. The best-accepted theory is that local anesthetics bind to sodium channels in nerves to inhibit action potentials. These agents also exhibit antimicrobial properties and can have prolonged effects with the addition of certain substances. Different approaches like infiltration, conduction blocks, and regional techniques are used for targeted pain relief.

• Local Analgesia
• Anesthesia
• Pain Relief
• Nerve Blocks
• Antimicrobial

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2. Local analgesiaanesthesia in localized area in body desensitization . May be surface analgesia i.e. benumbing (produced by ethyl chloride spray) or infiltrations, conduction / nerve block, regional analgesia ..epidural .true spinal ..lumbar segmental ..IVRA

3. Ester linked: Examples.cocaine, benzocaine, procaine,chloroprocaine, tetracaine .. readily hydrolyzed by plasma cholinesterase short half-lives when stored in solution without preservatives. Amide linked: Examples .. lidocaine, prilocaine, dibucaine, etidocaine, mepivacaine, bupivacaine, levobupivacaine, ropivacaine, articaine. very stable, cannot be hydrolyzed by cholinesterase, and rely on enzymatic degradation in the liver.

4. Ester linked Low potency, short duration Procaine Slow Fast 45 60 30 60 Chloroprocaine High potency, long duration Tetracaine Slow 60 360

5. Amide linked Intermediate potency, short duration Articaine Fast 30 45 Intermediate potency and duration Lidocaine Mepivacaine Prilocaine Fast Fast Fast 60 120 90 180 120 180 Intermediate potency, long duration Ropivacaine Intermediate 180 480 High potency, long duration Bupivacaine Levobupivacaine Etidocaine Intermediate Intermediate 180 480 180 480 180 480 Fast

6. Best accepted theory.. Local anesthetics bind to sodium-selective ionic channels in nerves, inhibiting the sodium permeability that underlies action potential and depolarization of the cell membrane. Electrical transmission through a myelinated axon stops when enough concentration of the anesthetic is applied to bathe at least three consecutive nodes of Ranvier.

7. Local anesthesia Anti microbial action .dose dependant .also act against E. coli, Pseudomonas Acts against candida sps Duration of action increases on addition of adrenaline (5mu g/ml or 1: 200000) Area of desensitization increases on addition of hyaluronidase

9. Infiltration Conduction block (nerve block) Regional (Brachial plexus, paravertebral, epidural, spinal)