Local anesthesia refers to temporarily numbing a small area by injecting local anesthetic into the skin so that minor procedures like stitching cuts can be done painlessly. Anyone who undergoes a painful procedure may be a candidate for local anesthesia. This type of anesthesia is usually used for minor procedures. Examples are getting sutures for a cut or having a tooth pulled. Local anesthesia can also be used for minor surgery, such as a hernia repair.

What can I expect before ?

Nowadays most patients come to the hospital on the day of their operation, and are seen by the anesthesiologist in the pre-anesthetic assessment clinic or the day of their scheduled surgical procedure. Before meeting the anesthesiologist you could be requested to answer to a questionnaire. This questionnaire will help you organize and provide important information for your anesthesiologist. You can choose your anesthesiologist, though the multiple duties and assignments shared by the anesthetic staff may make it logistically difficult to have a given member of the staff available on the day of your operation. Please check with your surgeon about your local situation. He or she will review your medical history, examine you, and order any necessary laboratory tests, electrocardiogram (EKG) and chest X-ray. He or she will make sure that any medical conditions, which might complicate your anesthetic, are being treated as well as possible. The history should include past and current medical problems, current and recent drug therapy, unusual reactions or responses to drugs, and any problems or complications associated with previous anesthetics. A family history of adverse reactions associated with anesthesia should also be obtained. lnformation about the anesthetic that the patient considers relevant should also be documented. Occasionally, the anesthesiologist will request an opinion from another specialist, such as a cardiologist, to help in your assessment. The different types of anesthesia appropriate for you and the relative risks according to the American Society of Anesthesiologists Physical Status Classification and New York Heart Association Classsification will be explained. Very rarely, your operation may be postponed or cancelled because of the risks involved. The anesthesiologist who is assigned to look after you on the day of your operation will review this information, and make the final decision with you about the details of your anesthetic. Your anesthesiologist will inform you about NPO (nothing per os): on the morning of surgery, you should have nothing to eat or drink. You may brush your teeth or rinse your mouth, but you should not eat or drink anything. If, however, you routinely take medications for your Blood Pressure or Heart in the morning, you should take your usual medications with a sip of water.

What can I expect during ?

Local numbing medication is injected into the skin or other surface at the site of the procedure. The injection is usually near the surface, but may be deeper in some cases. The site of the procedure is first cleaned with an antibacterial cleanser. The medication used to numb the area is then injected using a very small needle. The medication may cause a stinging or burning sensation at first. This discomfort lasts for just a few seconds.

It takes a few minutes for the medication to have its full effect. The person should be unable to feel pain in the treated area. A pressure sensation may be felt when the area is cut or poked with needles. But pain should be absent. If pain is felt, the person should tell the healthcare provider. More medication can be injected to control pain. If a person is anxious, sedative medication can be given. The sedative may be a pill or may be given through an intravenous line (IV) inserted into the vein of the arm or hand. This medication can help the person relax. This procedure is called MAC (Monitored Anesthesia Care). The numbing medication generally wears off within an hour of the procedure. Procedures that use local numbing medication are usually minor. A person may be able to go home soon after a minor procedure, such as getting sutures. If sedatives were used, someone else must drive the person home. This is because sedatives can impair coordination and reflexes for several hours.

What can I expect after ?

Local anesthesia requires no home care. But the procedure itself may require monitoring and treatment. The procedure usually causes more problems at home than the medication. The person may feel some discomfort at the procedure site as the numbing medication wears off.

What are the risks ?

While local anesthetics are widely and successfully used to provide pain relief, they are not without potential problems. In addition to the numbing effect they have on nerves, they also have actions on the brain and heart. If too much local anesthetic enters the circulation, it can cause a convulsion or a disturbance of heart rhythm. For this reason there are limits concerning how much local anesthetic medication is safe to administer. In addition, epinephrine (adrenaline) is often added to the local anesthetic solution because it constricts blood vessels, thus reducing blood flow to the area, thus the slowing absorption and lowering the blood levels of the local anesthetic drug. Many patients think themselves to be allergic to local anesthetics because of the way the epinephrine makes them feel (anxious, apprehensive, heart racing). However, such symptoms are not signs of a true drug allergy but rather just the actions of small amounts of epinephrine that have gotten into their systems; local anesthetic drugs can safely be used in these patients.