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- Loss of sensation in a limited region of the body
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- Localized analgesia
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- Drug delivered to target
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- aka "regional anesthesia"
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> Uncharged form is more lipid soluble
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> Lower the pKa, the greater the percentage of unchanged weak base at a given pH
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> Basic drugs: more will be lipid soluble form at alkaline pH
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> Exists as weak bases
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> pKa of most LA agents ranges 7.5 to 9.0
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mainly exist in cationic form at physiologic pH
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> Benzocaine (pKa 3.5)
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exists mainly in non-ionized form at physiological pH
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> Cationic form is most active at receptor site
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receptor site at the inner vestibule of the sodium channel
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CNS
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sedation, light headedness, visual and auditory disturbances
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tongue numbness and metallic taste
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tonic-clonic convulsions (at higher dose)
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Cardiotoxicity:
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Profound effects on conduction and function
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Heart Block
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Surface anesthesia:
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lidocaine, benzocaine, tetracaine
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Infiltration anesthesia:
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most agents, minor surgeries
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Nerve block:
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most agents, for surgery, dentistry and analgesia.
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Spinal anesthesia:
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mainly lidocaine
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