Herzliya Medical Center
If you’re facing surgery that will be done under local anesthesia, you’ll surely want to know as much as possible about the process and the way the anesthesia is done. It’s important that you come prepared. The more prepared you know the calmer you’ll be and your anxiety level would decrease.
In general, even local anesthesia is done to prevent you, the patients, from feeling pain during the medical procedure – mostly surgery. The local anesthesia, as its name suggests, is anesthesia within which a very specific part of the body is ‘put asleep’ for a specific procedure. When you’re under local anesthesia, you’re fully awake and only a very certain part of the body remains senseless to enable the medical procedure without any pain.
In contrast to general anesthesia, where the patient is completely under, unaware of the surrounding, can’t hear or feel a thing, in local anesthesia, you’re fully conscious and well aware of what’s happening around you. The fact the surgery area is sedated ensures you won’t feel pain, but you might indeed feel discomfort or even light pressure in the treated area.
The local anesthesia can be used for a variety of medical procedures. It’s very common in dental care, but also used in mole resection, limb surgeries (example: surgery on the palm), plastic surgery and more. Today, even brain surgeries are done under local anesthesia in cases where there is significance in the patient remaining awake to make sure not brain damage is caused throughout the treatment. Local anesthesia isn’t used just in surgeries, but also in biopsies, a procedure where a tiny tissue sample is taken from a specific part of the body.
By the way, some people have concerns about medical procedure under local anesthesia because they have to stay fully conscious during the procedure. Usually, those are patients that the mere presence in the treatment room causes them great discomfort and even anxiety. In such cases, the doctor can use sedatives that aren’t as deep and strong as local anesthesia substances, but will ensure foggy awareness throughout the procedure, which would make it significantly easier.
No special preparation is required in local anesthesia. There are procedures that are done under local anesthesia and require the involvement of the anesthesiologist. In such a situation, you might meet with the anesthesiologist before the surgery, but usually this is anesthesia the attending doctor could do himself, without the supervision of an anesthesiologist. In most cases in local anesthesia, you won’t need special preparation, and in contrast to general anesthesia, you won’t need to fast before the procedure.
The local anesthesia is mostly done via injection into the treated area, but it’s sometimes done by dripping the anesthetic directly onto the spot requiring treatment (usually drops for mucous anesthesia – a membrane that covers internal organs), via special spray containing anesthetics, ointment or gel.
Each of the ways we noted here can provide effective local anesthesia, and the choice of the right means depends on the area treated, the nature of the treatment, the doctor’s preference and more. The anesthetics work immediately on the treated area, meaning there’s no need to wait longer than a few minutes until the area is “asleep”.
All preparations used for local anesthesia contain numbing agents – morphine, opiates and more. These substances are divided into 2 groups – the amides and the esters. In the esters group there is, among else, cocaine, which is in fact the most volatile substance in use among the substances in this group.
The features of the anesthetics allows in fact to ‘sever’ the nerves and prevent sending electric signals to the brain, which prevents the sensation of pain. The severance is of course temporary: mostly after 1-2 hours, the effect of the substances will start to wear off completely.
One of the big advantages of local anesthesia is the short recovery process, especially compared to general anesthesia. Here, only a few hours are needed for complete recovery, and discharge is done after a relatively short period. Thus, for example, after dental treatment under local anesthesia, you can walk home several minutes after the end of the treatment, and even drive in most cases.
Even in this matter the local anesthesia is considered very “friendly”: side effects after this type of anesthesia aren’t common at all, and if they occur, it will usually happen due to the anesthetic dosage being too high, or an increased absorption of the anesthetic in the blood vessels. In these cases, they can be expressed in indigestion, vomiting, weakness, fatigue and even blurry vision. In very severe and rare cases, there might be impact on the nervous system and the heart.
Since all types of anesthesia are generally based on the same “family” of substances, if you know of sensitivity or allergy to an anesthetic, it’s very important you state that before you start the procedure even in local anesthesia. In this case, the staff will choose an alternative anesthetic from a “family” that doesn’t cause an allergic reaction.