New local anesthetics.

Jarna Shah, Effrossyni Gina Votta-Velis, Alain Borgeat

Journal: Best practice & research. Clinical anaesthesiology 2019;32(2):179-185

PMID: 30322458

Abstract

Local anesthetics are used for performing various regional anesthesia techniques to provide intraoperative anesthesia and analgesia, as well as for the treatment of acute and chronic pain. Older medications such as lidocaine and bupivacaine as well as newer ones such as mepivacaine and ropivacaine are being used successfully for decades. Routes of administration include neuraxial, perineural, intravenous, various infiltrative approaches, topical, and transdermal. There are new innovations with the use of older local anesthetics in a novel manner, in addition to the development and use of new formulations. This chapter seeks to summarize the pharmacokinetics of local anesthetics and address the role of newer local anesthetics, as well as clinical implications, safety profiles, and the future of local anesthetic research. Finally, some clinical pearls are highlighted.

Address: Department of Anesthesiology, University of Illinois Hospital and Health Services, Chicago, IL, USA.; Department of Anesthesiology, University of Illinois Hospital and Health Services, Chicago, IL, USA. Electronic address: [email protected].; Department of Anesthesiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland.

DOI: 10.1016/j.bpa.2018.06.010

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MeSH Terms: Anesthesia, Local, Anesthetics, Local, Bupivacaine, Drug Administration Routes, Humans, Lidocaine, Mepivacaine, Procaine, Sodium Channel Blockers