By.

Kurnia hendra wijaya MD

 preliminary
Anesthesia comes from the Greek
- An : No, without
- Aesthetos : Ability to feel

* In general, anesthesia is an act of relieving pain

during surgery

* In particular, local anesthesia means a reversible

loss of sensation by blocking the conduction of nerve
impulses in the tissues
 HISTORY
1892  synthetic local anesthetics were developed.
1905  Prokain and Benzokain
This was followed by many other derivatives such as
tetracaine, butacaine, and cinchocaine. Then came
modern anesthetics such as lidocaine, (1947),
mevicaine (1957), prilocaine (1963), and buvicaine
(1967).
TYPES OF MEDICINE INCLUDED IN LOCAL ANESTHESIA
Local anesthetic drugs can be classified chemically in
several groups, as follows:

 Compound - ester (PABA)

 Compound - amida

Others
 Pharmacology
based on the potential and duration of work become:
Group I includes procaine and chloroprocaine
which have weak potency with short duration of
action.
Group II includes lidocaine, mepivacaine and
prilocaine which have moderate potency and
duration of action.
Group III includes tetracaine, bupivacaine and
etidocaine which have strong potency with long
duration of action.
 SIDE EFFECTS
a result of its depressant effect on the CNS
and its cardiodrepressive effect (suppressing
heart function) with symptoms of
respiratory and blood circulation inhibition.
can also cause hypersensitivity, which often
ranges from exanthema, urticaria, and
allergic bronchospasm to anaphylactic
shock which can be fatal.
 Complications of Local Anesthesia

1. Local complications
Can occur when the injection is punctured
by a large blood vessel or in patients with
bleeding disorders or who are receiving
anticoagulant therapy to form hematoma,
infiltrates and abscess.
2. Systemic complications
Usually occurs due to negligence when
injecting local anesthetic drugs so that they
enter the systemic or intrathecal circulation.

 Broadly speaking, this can happen because

of 4 things, namely:
- Hypersensitivity
- Overdose
- Intravasation
- Hyperabsorption
Symptoms of Systemic Complications

1. Central Nervous System

The initial symptoms are
lightheadedness, dizziness, then
followed by visual and hearing
disturbances in the form of blurred
vision and ringing in the ears.
2.Cardiovascular effects.
Local anesthetics can act directly on the
purkinje fibers of the cardiac ventricular muscle,
causing bradycardia.

3. Allergic reaction.
It can only be in the form of redness of the skin,
urticaria to fatal anaphylactic shock.

4. Etc.
Another complication that can sometimes occur
is chills.
 LOCAL ANESTHESIA
TECHNIQUES
Surface Anesthesia (Topical)
Effective surface anesthesia can be achieved by cooling
the skin to 4 degrees Celcius.

Indications  insertion of a nasotracheal tube in

pediatrics, diagnostic/operative bronchoscopy,
cystoscopic procedures, removal of the corpus
alineum in the eye and opening a blocked nose
Infiltrate Anesthesia
aims to cause anesthesia of nerve endings by
injection into or around the tissue to be
anesthetized, causing loss of sensation in the
skin and deeper tissues.

Indications  Teeth with extensive caries,

Periapical or interradicular infections,
impacted primary teeth, decubitus ulcers,
orthodontic treatment, Supernumerary
teeth, and teeth causing dentoalveolar
abscess
ANESTESI BLOK
ANESTHESIA BLOCK

a). Spinal Anesthesia

Spinal anesthesia is regional anesthesia with the
action of injecting local anesthetic drugs into the
subarachnoid space, spinal anesthesia is also
known as analgesia or intradural spinal block or
intrathecal block.

Indication  Actions involving the lower limbs,

pelvis, and perineum. It is also used in special
situations such as endoscopic surgery, rectal
surgery, hip repair, obstetric surgery, and
pediatric surgery
b). Epidural Anesthesia
is a form of neuraxial block
technique, where its use is wider than spinal
anesthesia.

This can be done through a lumbar, thoracic,

cervical or sacral approach (commonly called a
caudal block).

Indication  in operative anesthesia, analgesia for

obstetric cases, postoperative analgesia and for
chronic pain management.
c). Caudal Anesthesia

a form of epidural anesthesia that is injected through

a different place, namely into the sacral canal through
the sacral hiatus.
Thank you miss didi and my friends,Can Do it !!!