The use of local anaesthetics in dermatology, aesthetic medicine and plastic surgery: review of the literature

Abstract

The aim of the study is to present the latest information on local anaesthesia in plastic surgery, aesthetic medicine and dermatology based on the available literature. The aim of the work is to present a model of cooperation between an anaesthesiologist, dermatologist, and surgeon, so that the patients feel safe, and, above all, the procedure will be comfortable and painless for them. Regional blocks are an excellent tool to achieve this goal. Achieving this requires commitment and understanding by both the plastic surgeon and the anaesthesiologist.

The Origins and Development of Pre-emptive Dermatologic Anesthesia: A Systematic Review

“…Among these new local anesthetics were the ester anesthetics, such as procaine, holocaine, orthoform, benzocaine, and tetracaine. These medications are comprised of hydrophilic particles that combine a tertiary amine with a lipophilic aromatic ring [ 11 ]. When in their ionized states, their mechanism of action involves blocking rapid sodium channels found in neuronal cell membranes.…”

“…For this reason, procaine quickly became the prototypical local anesthetic soon after its invention in 1905, just a year after Braun combined the use of epinephrine and cocaine. Nevertheless, these ester anesthetics often led to the occurrence of contact dermatitis [ 11 ].…”

“…Shortly following the esters were the amino amide local anesthetics, such as chloroprocaine, cinchocaine, lidocaine, mepivacaine, and prilocaine. Amides, like esters, are tertiary amines that work through a similar mechanism [ 11 ]. Lidocaine, the first non-ester anesthetic, quickly became a widely used agent in dermatologic procedures due to its increased potency and low side effect profile.…”

“…Bupivacaine with epinephrine is another amide anesthetic that has been widely adopted, primarily because of its longer onset and duration of action than lidocaine. Today, bupivacaine is used for epidural anesthesia and as regional blocker [ 11 ].…”