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Background
An amide-type local anesthetic that is currently commonly used for surface anesthesia. It is one of the most powerful and lethal long-acting local anesthetics, with parenteral application limited to spinal anesthesia.
Indication
Infiltration techniques such as percutaneous injection and intravenous regional anesthesia by peripheral nerve block techniques such as brachial plexus and intercostal blocks and central neural processes such as lumbar and caudal epidural blocks are used to produce local or regional anesthesia.
Mechanism of action
By decreasing the permeability of the neuronal membrane to sodium ions through sodium channel inhibition, local anesthetics limit both the initiation and conduction of nerve impulses. The membrane is reversibly stabilized, and depolarization is inhibited, leading to the failure of a propagated action potential and conduction blockage.
Absorption
Ionized versions of local anesthetics (salts) are not readily absorbed through intact skin in general. Nonionized (bases) and ionized forms of local anesthetics, on the other hand, are easily absorbed into the systemic circulation through scarred or irritated skin.
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