Local anaesthesia

“Is it going to hurt?” This question is often heard by any health worker who is related to surgery.

Defeat pain, relieve suffering: medicine for centuries "fights" with the enemies of human health diseases. Many of them require surgical treatment, which is accompanied by unbearable pain, but can be handled by local anesthesia.

As you would have guess, it is a method in which a local anesthetic acts only on that part of the body where it is needed that is where a medical professional plans to make a cut or other painful manipulation.

Anesthetic either penetrates into the tissues numbing them or is simply applied to a certain area. In skillful hands, local anesthesia is capable of miracles.

With local anesthesia, a patient usually feels an injection or application of a gel or an ointment, and then these sensations are replaced by a feeling of bursting, tension it is easily tolerable. In a short time there is a kind of "something is being done with me", but it does not hurt.

In some surgical procedures on soft tissues, such as the removal of small tumors, when treating wounds that do not penetrate the cavity, when removing foreign objects that are located near the surface of the skin in short, in "minor surgery" local anesthesia is convenient, safe and effective in all respects.

It is completely inapplicable only in cases of panic mood of a patient, with allergy to a medication used for the surgical manipulation (the most allergenic is novocaine, the least is lidocaine (Xylocaine)). Very limited is use of local anesthesia in children.

Now it is difficult to say where local anesthesia is not used, since it is indispensable in all branches of medicine:

• Dentistry (removal, dental treatment, prosthetics)
• Surgery (surgery on the limbs, lower floor of the abdominal cavity, dissection of abscesses)
• Urology (kidney surgery, prostatectomy, urography)
• Gynecology and obstetrics (various gynecological procedures, anesthesia during labor, Caesarean section)
• Traumatology (almost all surgical procedures)
• Proctology (various procedures)
• Gastroenterology (gastroscopy and sounding)
• ENT surgery
• Ophthalmological surgeries and many others

This is not a complete list of areas of application of local anesthesia, as it is used almost everywhere. Most likely, each of us at least once in life came across this kind of anesthesia.

Indications for local anesthesia

• Small cavitary surgeries, surgeries on soft tissues
• Severe concomitant pathology
• Refusal of a patient from general anesthesia
• It is best suitable for elderly people

Contraindications for the use of local anesthesia

• Patient refusal
• Allergy to anesthetics
• Mental illness
• Complexity and long duration of a procedure
• Scar tissue changes in the surgical intervention zone

In general, this type of anesthesia is quite harmless. But still, complications can arise both in infiltrative anesthesia (which is most often performed by surgeons without the participation of anesthesiologists) or with central blockades that are performed exclusively by anesthetists in a sterile operating theater, where there is all the necessary equipment to assist, if something goes wrong. This is due to the toxicity of some anesthetics, as well as its unintentional entry into the blood vessels. Most often, there are three types of possible complications:

• Violation of the CNS (the patient experiences unmotivated anxiety, dizziness, ringing in the ears, there may be convulsions and breathing arrest)
• Circulatory disorders (lowering of the blood pressure and bradycardia)
• Various kinds of allergic reactions, up to the most serious complication, anaphylactic shock

The benefits of local anesthesia include better tolerability than general anesthesia, a lower risk of side effects and complications. However it can’t be used in urgent surgery, and also that this type of anesthesia is not suitable for all surgical manipulations, and not all people agree to "attend their own surgery."