Learning unit: Local anaesthetics

Impact of the learning unit

Local anaesthetics are essential substances in the treatment of pain as they block transmission of
pain signals. The knowledge of the individual substances, their pharmacodynamics and
pharmacokinetic properties, typical adverse effects, indications and contraindications, is
considered to be the basic knowledge of each student of medicine.


Important terms

techniques of local anaesthesia

                               topical (surface) anaesthesia

                                               EMLA

                               infiltration anesthesia

                               conduction anaesthesia

                                               peripheral nerve block

                                               regional anaesthesia

                                               central conduction anaesthesia

                                                               subarachnoideal (spinal) anaesthesia

                                                               epidural anaesthesia

local anaesthetics (LA)

                mechanism of action

                pharmacokinetics

                factors influencing LA effects

                               pH

                               nerve fibre properties (thickness, myelinization)

                adverse effects of LA

                               CNS, cardiovascular, anaphylaxis, methemoglobinemia

                ester local anaesthetics

                               cocaine

                               procaine

                               tetracaine

                               benzocaine

                               oxybuprocaine


                amide local anaesthetics

                               trimecaine

                               lidocaine

                               bupivacaine

                               ropivacaine

                               prilocaine

                               articaine

                               mepivacaine

                               cinchocaine

vasoconstrictory agents used in LA


Learning outcomes


Student knows basic pharmacological profile (mode of action, unwanted effects, indications and
contraindications) of local anesthetics.


Student knows different techniques of local anaesthesia and their characteristics.

Student summarizes basic differences between amide and ester local anaesthetic agents.

Student gives examples of vasoconstrictor agents used in combination with local anaesthetics.


Study materials

Rang & Dale's Pharmacology, 8th edition, 2016, chapter 43, pp. 530-533 ( Local anaesthetics and
other drugs affecting sodium channels)

Study materials for courses aVLFA0721p and aVLFA0721c.


Exam questions

Special pharmacology:  17. Local anesthetics

Essential drugs: 49. procaine/lidocaine, 51. prilocaine