Local Anesthesia by by teachers@tatvakrishna

Local Anaesthesia

Local Anaesthesia is part of anaesthesia that is used for localized reversible loss of sensation.

 Type of local anaesthesia-

There are 4 types    –      S I N F

1. Surface Anaesthesia –

               Example- Xylocaine jelly 2%

                   Xylocaine viscous 4%

                   Xylocaine spray 10%

2. Infiltration Anaesthesia

3. Nerve block Anaesthesia   Xylocaine injection 1% or 2% with adrenaline        

4. Field block Anaesthesia Bupivacaine injection     

   Example- Xylocaine injection plain 1% or 2%

• Surface Anaesthesia –

  • It is used on skin as well as mucous membrane to get sensation loss of particular procedures.

  • In this, viscous, spray is used.

  • It takes approx 10 minutes for maximum effect.

Example are-  

• Foley catheterization- 10 ml Xylocaine jelly should be introduced threw urethral meatus and wait approx 10 min.

• Xylocaine jelly is used in nostril for ryles tube installation.

• Xylocaine jelly is used for probing and K/S change.

• Sometime pain killers are used along with local anaesthetic agent like Volini gel, spray.

• Infiltration Anaesthesia-

• In this type of anaesthesia local anaesthetic agent is introduced I/D or SC plain to achieve the reversible loss of sensation.

Example are–   

• Suturing after traumatic injury like incised

wound, lacerated wound.

• Skin infiltration at the site of incision in inguinal hernia surgery as well as hydrocele surgery.

 

• Nerve block Anaesthesia-

• it is very important type of anaesthesia.

• In this type nerve is block by giving anaesthesia solution just close to nerve.

Example are-

• Digital nerve block for figures and toes.

• Nerve block at 11 & 1 o ‘clock position for circumcision.

• Ilio inguinal nerve & genital branch of genitofemoral nerve block in inguinal hernia surgery.

• Brachial plexus block through supraclavicular approach for forearm surgery.

 

• Field block Anaesthesia –

• In this type of anaesthesia particular field is blocked by giving anaesthetic agent at periphery surface.

Examples are-

• Sebaceous cyst excision.

• Lipoma excision.

Dose of local anaesthesia-

• Xylocaine plain- 3 to 4 mg/kg/body weight

(If given in higher dose –>  Cardiac arrhythmia)

• Xylocaine with ADR- 7 mg/kg/body weight

• Bupivacaine – 2mg/kg/body weight

Complication of local anaesthesia-

1. Bleeding

2. Pain

3. Nerve injury

4. Vascular injury

5. Cardiac arrhythmia

6. Hypertension

7. Paralysis