Local Anaesthetics

Author: Graham Gardner / Editors: Adrian Boyle, Chris Gray / Reviewer: Michael Perry / Codes: A6, CC5, PP13, PP9 / Published: 12/09/2022

Local anaesthetics are amongst the most widely used drugs in any emergency department. It is, therefore, essential that emergency medicine clinicians can use these drugs safely and effectively.

After completing this session you will be able to:

  • Describe the pharmacology of local anaesthetic agents
  • Compare local anaesthetic options
  • Explain how to plan the safe use of local anaesthesia though infiltration and nerve blockade
  • Describe how to manage complications of local anaesthetic usage


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  3. Electronic medicines compendium. Lidocaine Hydrochloride Injection BP 2% w/v. [Accessed 8 July 2022].
  4. British National Formulary online edition. Lidocaine Hydrochloride. [Accessed 8 July 2022].
  5. Electronic medicines compendium. Xylocaine 1% with Adrenaline. [Accessed 8 July 2022].
  6. Electronic medicines compendium. Bupivacaine & Adrenaline (Epinephrine) Injection BP 0.5% w/v, 1 in 200,000. [Accessed 8 July 2022].
  7. Electronic medicines compendium. Minims Tetracaine Hydrochloride 1.0% w/v, Eye drops solution. [Accessed 8 July 2022].
  8. Prabhakar H, Rath S, Kalaivani M, Bhanderi N. Adrenaline with lidocaine for digital nerve blocks. Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No.: CD010645. [Accessed 8 July 2022].
  9. Boyd R, Jacobs M. EMLA or amethocaine (tetracaine) for topical analgesia in children. BestBETs, Best Evidence Topics 2000, updated 2004.
  10. Strazar AR, Leynes PG, Lalonde DH. Minimizing the pain of local anesthesia injection. Plast Reconstr Surg. 2013 Sep;132(3):675-684.
  11. GMC. Decision-making and consent.
  12. AAGBI. Management of severe local anaesthetic toxicity guidelines. Association of Anaesthetists. 2010.

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