General information
Local anesthesia is the temporary elimination of local nerve transmission in the body, especially pain perception. This is a local anesthesia. It is mainly used for smaller and uncomplicated operations.
The local anaesthetic differs significantly from anaesthetics such as morphine because it has neither a euphoric nor an addictive effect. Local anaesthetics achieve their effect by reversibly, i.e. not permanently, reducing the sensation of skin, muscles and the correspondingly treated organ area to such an extent that the patient does not feel any pain. In contrast to general anesthesia, the patient remains conscious and breathes independently. The terms “local anesthesia” or “regional anesthesia” are usually used synonymously.
Fields of application
Nowadays, many surgical procedures and painful examinations are performed under local anesthesia: In addition, great success can be achieved in pain therapy. Local anesthetics are enjoying increasing popularity. On the one hand, this is due to the fact that their duration of action is very short and the patient is not unnecessarily burdened.
On the other hand, the patient can leave the clinic after a short in-patient stay due to the unproblematic treatment, which results in less costs for the clinic and less trouble for the patient. However, since local anesthetics, as the name suggests, only work locally, i.e. in a limited area, they can only be used in certain areas and only for minor procedures. On the one hand, local anesthetics are suitable for superficial pain relief.
For example, the removal of moles is not performed under general anesthesia, but the patient is only given a sufficient amount of local anesthetic at the affected area to stop the pain associated with the procedure. The treatment of hemorrhoids (painful dilatation of blood vessels in the area of the anus) is also performed with the help of local anesthetic. In addition, in the so-called minimally invasive procedures, only a local anesthetic is used in order not to harm the patient unnecessarily.
These include, among other things, the removal of the appendix and, in older patients, the insertion of a so-called stent into a blood vessel. Such a stent is inserted under local anesthesia through the A. femoralis communis (the large artery in the area of the thigh) into the vascular system and is inserted into the occluded vessel using special imaging techniques (usually using X-rays, CT or MRI images). With the help of a stent, for example, a blood vessel at the heart, which was previously very narrow, can be dilated again.
Since the operation is only performed under local anesthesia, it is also well tolerated by older patients and the patient does not have to endure unnecessarily long hospital stays. Especially in dentistry, the so-called infiltration anesthesia is very popular. In this procedure, a pain-stopping medication is injected into the fatty tissue.
Here the local anaesthetic blocks the sensitive nerves, i.e. those nerves that would normally transmit the information about the origin of the pain to the brain. Since the pain information no longer reaches the brain, the dentist can, for example, pull out the wisdom teeth, or that the patient is conducting while in pain. However, since only the pain is eliminated, the patient is still fully aware of the treatment itself.
Among other things, this can also lead to an unpleasant feeling of pressure, which is not associated with pain, but still shows the patient clearly whether the tooth is already out or whether the dentist still has to pull further. Nevertheless, these slightly unpleasant side effects are accepted, since a general anesthesia is too high an unnecessary risk for the patient in a rather small operation. However, local anaesthetics are not only used during operations.
Due to their pain-relieving effect, great success can be achieved in pain therapy. More and more frequently, there are also gels, creams and sprays that contain a local anaesthetic in low to high doses. These can be used, for example, for severe muscle pain, but also for patients with eye pain.In addition, many patients with severe coughing and the resulting sore throat receive a reduced dosage of local anesthetic to relieve the sore throat and thus to be able to eat and speak better again.
Whether local anesthetics should be used also with itching or for pain relief with sun burn is controversial there in this case the local anesthetic the actual problem not treated. In general it is important to say that a local anaesthetic only inhibits the transmission of pain. This is of course a desired effect in an operation.
In the case of sore throat, for example, the application should be viewed critically because the cause of the sore throat must first be clarified. One should always first treat the underlying disease (in this case the sore throat). Afterwards one can also prescribe a local anesthetic to the patient so that he is not hindered by the pain.
In addition to the already mentioned areas of application, local anesthetics are also used for cardiac arrhythmia.
- Operations on arms and legs (e.g. foot block), including shoulder and hip joint
- Superficial interventions on skin and mucous membrane
- Dental treatments
- Obstetric measures (e.g. “Caesarean section”)
- Operations on the lower abdomen (e.g. on the bladder, prostate or the sexual organs)
- Operations in the anal region (e.g. removal of hemorrhoids)
- Vascular surgery of the carotid artery
