Methods Of Local Anesthesia

(1) Surface anesthesia is defined as the painless state caused by the blocking of superficial nerve endings by local anesthetic with strong osmotic effect in contact with local mucosa. Local anesthetics used in surface anesthesia are difficult to reach the subepithelial pain receptors and can only relieve the discomfort caused by mucosa. It can be used for surface anesthesia of cornea, nasal cavity, larynx, trachea and bronchus.

(2) Precautions ① Before the cotton tablets impregnated with local anesthetics are applied to the mucosal surface, the excess liquid should be squeezed out to prevent excessive absorption and toxic reaction. Cotton pad filling should be carried out under headlamp or laryngoscope to facilitate correct placement [2]. ② The absorption rate of local anesthetics was different in different parts of mucous membrane. Generally speaking, the application of high concentrations and large doses of local anesthetics on large mucosal tracts is prone to toxic reactions, and in severe cases, fatal. The mucosal absorption rate of local anesthetics is equal to that of intravenous injection, especially with tracheal and bronchial spray, the absorption rate of local anesthetics is the fastest, so the dose should be strictly controlled, otherwise a large number of local anesthetics can inhibit the myocardium and the patient will collapse quickly, so resuscitations and drugs should be prepared in advance. ③ Atropine should be injected before surface anesthesia to dry the mucosa and avoid saliva or secretions that hinder the contact between local anesthetics and the mucosa. (4) The local anesthetic ointment applied on the outer wall of the tracheal tube is best water-soluble, and it should be noted that the anesthetic effect takes at least 1 minute. Therefore, it is not expected that the tracheal tube can prevent choking once inserted, and spray surface anesthesia of pharynx, larynx and tracheal mucosa should be performed before conscious intubation.

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