Local anesthetics
- Reversibly block voltage-gated Na channels
- Local, regional, neuraxial anesthesia
- Lidocaine also treats ventricular arrhythmia
- CNS toxicity precedes severe cardiac toxicity
- Bupivacaine is especially cardiotoxic
- Epinephrine prolongs some local blocks
- Severe LAST → IV lipid-emulsion rescue
Class at a glance
- Reversibly block voltage-gated Na channels
Pharmacology
- Epinephrine prolongs some local blocks
Clinical role
- Local, regional, neuraxial anesthesia
- Lidocaine also treats ventricular arrhythmia
- Severe LAST → IV lipid-emulsion rescue
Safety / monitoring
- CNS toxicity precedes severe cardiac toxicity
- Bupivacaine is especially cardiotoxic
Self-check
- How does Local anesthetics work?
Reversibly block voltage-gated Na channels. - What is the rescue for severe local-anesthetic systemic toxicity (LAST)?
IV lipid emulsion.
Drugs in this class (8)
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