Introduction to local anaesthetics for acute pain management

This topic focuses on the role of local anaesthetics for acute pain management; their role in chronic pain is limited.

Local anaesthetics block conduction in sensory, motor and autonomic nerves. When local anaesthetics block sensory input, they can decrease or eliminate the need for other analgesics. This may result in fewer analgesic adverse effects (eg sedation), increased patient satisfaction, faster return to normal function, and decreased length of hospital stay.

Commonly used local anaesthetics include bupivacaine, levobupivacaine, lidocaine, prilocaine, ropivacaine and tetracaine (amethocaine). Depending on the formulation, they can be applied topically or administered via subcutaneous or intradermal injection. Local anaesthetics can also be administered into an anatomical space or plane to achieve blockade of a larger region of the body (eg intravenous regional blocks, peripheral nerve blocks, neuraxial blocks).