Local anaesthesia for procedures and minor surgery
Pain control in a limited area of the body for the duration of a procedure: wound closure, mole removal, dental work, puncture, catheterisation, epidural anaesthesia in labour. The drug goes next to a nerve or straight into the tissue, and the person stays awake. The clinician covers the painful zone while staying under the maximum dose, because local anaesthetics reach the bloodstream and at high concentration hit the central nervous system and the heart.
2 drugs
Also known as: Infiltration anaesthesia, Nerve block, Epidural anaesthesia, Regional intravenous anaesthesia
Drugs used for this condition
- ALidocaineFirst line · Amide-type local anaesthetic and class Ib antiarrhythmic (systemic use, codes C01BB01 and N01BB02)The AEMPS Lidocaína Normon label gives the drug four routes: infiltration anaesthesia, intravenous regional anaesthesia, nerve block and epidural anaesthesia. Onset comes within minutes and the effect holds for an hour to an hour and a half, longer with adrenaline, because the vasoconstrictor slows absorption. The main limit is total dose rather than solution strength: lidocaine leaves the tissue for the bloodstream, and once the dose is exceeded, local anaesthetic systemic toxicity unfolds. The first signs are neurological: metallic taste, numbness around the mouth, ringing in the ears, agitation, then seizures, and only afterwards a fall in blood pressure and arrhythmia. The label warns separately that in a patient already receiving another local anaesthetic or a class Ib antiarrhythmic the toxic effects add up.
- CBenzocaineAdd-on therapy · Local anesthetic, aminobenzoic acid esterBenzocaine is a surface anesthetic for the mouth lining. In Spain it is sold over the counter as a spray and a gel, and the AEMPS ficha técnica sets out the use precisely: local relief of dental and oral mucosal pain in adults and children from 6 years, no more than 3 to 4 times a day. Only the surface goes numb, so benzocaine helps before an anesthetic injection, with a denture sore or an aphthous ulcer, while pain from pulpitis or an abscess is merely dulled and its cause stays. While the numbness lasts, eating, drinking and chewing gum are unsafe: biting the tongue or choking comes easily. The ficha also warns about contact dermatitis, taste disturbance and methemoglobinemia in overdose. Benzocaine does not treat the tooth: when pain returns for a third day, a dentist is needed rather than another dose of spray.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit