INTRODUCTION TO

BASICS OF LOCAL
ANESTHESIA
DR AMNA MUZAFFAR
BDS FCPS
ASSISTANT PROFESSOR ,OMFS
LAYOUT
 Introduction
 Definitions
 Desirable properties
 Impulse propagation and spread
 Mechanism
 Pharmacology
 Classification
 Equipment
WHAT IS PAIN????
……….……..Pain is basically An unpleasant
sensation that can range from mild, localized
discomfort to agony………….
 What is TRYPANOPHOBIA???
FEAR OF NEEDLES
PAIN CONTROL IN DENTISTRY
INTRODUCTION
 Local anesthetic: produce loss of sensation to
pain in a specific area of the body without
the loss of consciousness 
DEFINITIONS
 Anesthesia refers to loss of all forms of
sensations including pain, touch, temperature
and pressure perception and maybe
accompanied by impairment of motor function.
 Analgesia is a loss of pain sensation
unaccompanied by loss of other forms of
sensibility.
 Local Anesthesia is described as a loss of
sensation in a specific area of the body by
depression of excitation in nerve endings or an
inhibition of the conduction process in peripheral
nerves
 An important feature of local anesthesia is that
it produces: LOSS OF SENSATION WITHOUT
INDUCING LOSS OF CONSCIOUSNESS
PROPERTIES OF IDEAL LOCAL
ANESTHETIC
 Non irritant
 No permanent alteration of nerves
 Low systemic toxicity
 Effective
 Shortest possible time of onset
 Adequate duration of action
 Potent enough to give complete anesthesia
 Should not cause allergic reactions
 Stable in solution and readily undergo
biotransformation
 Sterile or capable of being sterilized
IMPULSE PROPOGATION AND
SPREAD
 Nerves transmit sensations as a result of
propagation of electrical impulses; this
propagation is accomplishes by alternating the
ion gradient across the nerve cell wall,
axolemma.

 Resting membrane potential (-70mV)

freely permeable to K+
slightly permeable to Na+
freely permeable to Cl-
MECHANISM
Local anesthetic agent interferes with
excitation process in a nerve membrane in
one of the following ways:
 Altering the basic resting potential of nerve
membrane
 Altering the threshold potential
 Decreasing the rate of depolarization
 Prolonging the rate of repolarization
MECHANISM OF ACTION
 Specific receptor theory – most favoured
theory
 Local anesthetics act by binding to specific
receptor on sodium channel
 Site for local anesthetics either exist on
external surface or on the internal
axoplasmic surface of sodium channel
 Permeability of sodium ions is decreased or
eliminated and nerve conduction is
interrupted
Limit influx of sodium, thereby limiting propagation of the
action potential.
DISSOCIATION OF LOCAL
ANESTHESIA
 Available as acid salts in solution form (water
or saline)
 In solution it exists as RN BASE (uncharged
molecule ) and CATION RNH+ (positively
charged molecule )
RNH RN + H
 Normal tissue pH - 75% RNH+ and 25% RN
 In presence of low pH (high conc. Of
hydrogen ions),most solution exist in cationic
form
RNH > RN + H
PHARMACOLOGY
 All local anesthetics are weak bases
 Chemical structure of local anesthetics have
an amine group on one end connect to an
aromatic ring on the other side
  The amine end is hydrophilic (soluble in
water), and the aromatic end is lipophilic
(soluble in lipids)
 Two classes of local anesthetics are amino
amides and amino esters
COMPARIS0N OF ESTERS AND
AMIDES
 AMIDES
 Amide link between
intermediate chain and
aromatic ring
 Metabolized in liver
 Slowly metabolized
 Systemic toxicity more likely
 Allergic reaction rare
 Very stable chemically
 Moderate to fast mode of
action
 ESTERS
 Ester link between
intermediate chain and
aromatic ring
 Metabolized by plasma
cholinestrases
 Rapidly metabolized
 Systemic toxicity Less likely
 Allergic reaction possible via
PABA derivative formation
 Susceptible to heat, sunlight
 Slow mode of action
EQUIPMENT
 Syringes
 Needles
 Cartridges
SYRINGES
Types:
Disposable / Re-usable
Aspirating /Non aspirating
(Conventional)
NEEDLES
Short (Infiltration) 20 – 25 mm
Long (Block Type) 35 – 41 mm

25/27/31 Gauge
CARTRIDGES
 THANKYOU