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DEFINITION
LOCAL ANAESTHESIA

Local anaesthesia is the loss of sensation in a


circumscribed area of the body caused by a
depression of excitation in nerve endings or an
inhibition of the conduction process in peripheral
nerves.
LOCAL ANAESTHETICS

Local anaesthetics are drugs that have little or


no irritating effects when injected into the tissues
and that will temporarily interrupt conduction
when absorbed into the nerves.
eg. : Lignocaine, Procaine, Xylocaine
IDEAL REQUIREMENTS OF
LOCAL ANAESTHESIA

h The action must be reversible.


h Non--irritating to the tissues.
Non
h No secondary local reactions.
h Low degree of systemic toxicity.
h Rapid onset & sufficient duration of action.
h Potency sufficient to render complete anesthesia.
IDEAL REQUIREMENTS OF
LOCAL ANAESTHESIA ± (cont)

h Potency sufficient to render complete anesthesia.


h Sufficient penetrating properties.
h Non--allergenic.
Non
h Stable in solution.
h Undergo biotransformation readily in the body.
h Sterile.
CLASSIFICATION OF
LOCAL ANAESTHESIA

( I ) BASED ON CHEMICAL COMPOSITION

( A ) ESTER GROUP

( B ) NON ESTER GROUP


ESTER GROUP
A.Benzoic acid esters :
1.Cocaine(topical only).
2.Benzocaine(topical).
B.Para--aminobenzoic acid esters :
B.Para
1. Procaine.
2. Tetracaine.
3. Propoxycaine.
NON ESTER GROUP
AMIDES
*Atricaine
*Lignocaine
*Bupivacaine
*Prilocaine
QUINOLONES
*Centbucridine
Based on duration of action
1) Short duration (apprx.30 minutes)

Lignocaine HCl 2%
Mepivacaine HCl 2%
Prilocaine HCl 4%
Based on duration of action

Intermediate duration (apprx.60 minutes)

*Lidocaine HCL 2% + Epinephrine 1:100000


*Atricaine HCl 4% + Epinephrine 1:200000
*Prilocaine HCl 4% + Epinephrine 1:200000
Based on duration of action

Long duration (apprx. 90+minutes)

Bupivacaine HCl 0.5%+Epinephrine


1:200000
(III ) BASED ON BIOLOGICAL
SITE AND MODE OF ACTION
Class A
Acting at receptor site on external surface of nerve
membrane
eg. : Biotoxins

Class B
Acting at receptor site on internal surface of nerve
membrane
eg. : Scorpion venom,Quaternary ammonium analogues of
lidocaine
(III) BASED ON BIOLOGICAL SITE
AND MODE OF ACTION

Class C
Acting by a receptor-
receptor-independent physiochemical
mechanism
eg. : Benzocaine

Class D
Acting by combination of receptor and receptor
independent mechanisms
eg. : Articaine, Lidocaine, Prilocaine
COMPOSITION OF LOCAL
ANAESTHETIC SOLUTION
h Local anaesthetic
h Vasoconstrictor
h Antioxidant
h Preservative
h Fungicide
h Salt
h Vehicle
LOCAL ANAESTHETICS

h May be an amide or an ester.


VASOCONSTRICTOR

h Epinephrine is used as a vasoconstrictor


- Causes vasoconstriction and prevents
rapid absorption.
- It produces desired effect at lower
dose of L.A.
- It reduces systemic toxicity.
- It also causes hemostasis.
ANTIOXIDANT

Sodium metabisulphite

It delays rapid oxidation of vasoconstrictor


and prolongs the shelf life of the solution
PRESERVATIVE

Methyl paraben

FUNGICIDE

Thymol
SALT

Bicarbonate is added to make the solution


isotonic
VEHICLE

h Distilled water or ringer lactate solution


h Helps to dissolve the content of L.A to
make it injectible.
h Also reduces the concentration of the drug
which provides additional volume for
injection.
EACH ML CONTAINS

h Lignocaine HCl 21.33 mg


h Adrenaline Bititrate 0.0225 mg
h Sodium Chloride 6.0 mg
h Sodium Metabisulphite 0.5 mg
h Methyl Paraben 1.0 mg
h Water for injection q.s