what is anesthesia?
who administers anesthesia?
who gets what type
local anesthesia: topical, cold, cream
injection, tumescent, ring block, regional block
IV sedation / monitored
stages of general
preparing for anesthesia
anesthesia and herbal
anesthesia and prescription
Types of Anesthesia
Local anesthesia numbs a particular area of the body,
and is overall safer than general or systemic anesthetics.
The term local anesthesia includes a number of different
techniques: topical, injected (infiltrative), tumescent
(a special technique using dilute concentrations), and
nerve blocks. While local anesthesia is very safe, there
are risks of complications such as pain, bruising, hematoma
(blood collecting under the skin), infection, allergic
reaction, and nerve damage.
Lidocaine toxicity is a rare complication that can
occur when anesthetic levels become too high. Reactions
ranging from ringing in the ears and dizziness to convulsions
and cardiac arrest (in severe cases) can result. During
some procedures using local anesthesia, your doctor
or a nurse may connect you to equipment that will monitor
your heart rate, blood pressure, and blood oxygen levels.
With the topical method of local anesthesia, pain
is modified or blocked directly at the surface of
the skin or mucous membranes (for instance, if incisions
or injections will be placed in the mouth). Topical
anesthesia will numb the uppermost layers and a little
bit below, but does not block pain in deeper structures.
It can be carried out by applying cold (e.g. ice)
or medicine in a cream or gel form. In addition to
being useful for minor procedures, it is also helpful
for people who are afraid of needles since topical
anesthesia will reduce or eliminate the discomfort
as the needle pierces the skin.
"Cryo-anesthesia" uses cold to produce
numbness that lasts for only a very short period of
time (usually less than 10 seconds). This can be accomplished
with ice, refrigerant sprays, or liquid nitrogen.
If ice or cold packs are used, it should be applied
directly to the site for 30-60 seconds. Cryo-anesthesia
is also used with several skin laser machines that
quickly spray a little coolant before each laser pulse
to take away the sting of the laser.
Cream anesthetics, such as the trade names EMLA,
Betacaine, or Ela-Max (now with a new name, LMX),
combine local anesthetics into formulations that are
able to penetrate the skin. EMLA cream, the most popular
topical anesthetic, must be applied directly to the
surgical site and covered with plastic for 1-3 hours
before the procedure. Covering, known as occlusion,
will help push the medicine into the skin rather than
leave it sitting on the outer surface. Ela-Max and
Betacaine need only be applied for 15-45 minutes,
and do not need to be covered to work. Ela-Max (LMX)is
now available without a prescription.
To Next Section
- Local Anesthesia: Injection, Tumescent, Ring Block
and Regional Block