What is Infiltrative Administration of Local Anesthetic Agents?
Local anesthetic agents are used for minor surgical and dental procedures.
Uses for infiltrative local anesthetics include:
- Subcutaneous infiltration (IV placement, superficial/shave skin biopsy, suturing)
- Submucosal infiltration (dental procedures, repairing cuts or incisions)
- Wound infiltration (postoperative pain control at an incision site)
- Intraarticular injections (postsurgical pain control, arthritic joint pain control)
- Infiltrative nerve blocks (ankle block, scalp block, digit block)
How do Doctors Perform Infiltrative Administration of Local Anesthetic Agents?
Local anesthetics can usually be used at lower concentrations for infiltration anesthesia. The dose of local anesthetic used depends on the procedure, the degree of anesthesia required, and the individual patient's condition.
Infiltrative administration of local anesthetic agents involves:
- The local anesthetic solution may be warmed to 77-104 F (25-40 C) prior to administration for patient comfort
- The local anesthetic solution may be administered:
- Intradermally (between the layers of the skin)
- Subcutaneously (under the layers of the skin)
- Submucosally (under mucosal tissue) across the nerve path that supplies the area of the body that requires anesthesia
- A common technique for infiltrative administration involves injection of a local anesthetic subcutaneously in a circular pattern around the operative site (field block technique)
What are Risks and Complications of Infiltrative Administration of Local Anesthetic Agents?
Side effects of local anesthetics are generally a result of:
- Accidental intravascular injection
- Too much anesthetic injected
- Excessive rate of injection (injected too quickly)
- Delayed drug clearance (body metabolizes the drug too slowly)
- Administration into tissues with high rates of clearance (body metabolizes the drug too quickly)
Side effects of local anesthetics include:
- Central nervous system (CNS) stimulation followed by CNS depression
- Heart problems
- Allergic reactions/hypersensitivity reactions
- Temporary burning sensation
- Skin discoloration
- Nerve inflammation (neuritis)
- Tissue death and sloughing
- Low levels of oxygen delivered to the cells (methemoglobinemia - with prilocaine use)