Local anesthetics.

BACKGROUND: Dermatology is dependent upon the effects of local anesthetics for diagnostic and therapeutic interventions. A working knowledge of the drugs' actions and interactions is necessary for anyone aspiring to optimize the benefits derived from the use of local anesthetic agents.

OBJECTIVE: This article reviews nerve physiology, pharmacology, classification of local anesthetics, adverse reactions (toxic, drug, allergic), local anesthetic use in pregnancy, alternatives to the "-caine" anesthetics, methods for reducing the pain of infiltration, and new agents under development.

CONCLUSION: Local anesthetics are safe and effective. With the understanding of the actions and interactions of this class of drugs, maximum patient safety and satisfaction can be achieved.