local anaesthesia

Last reviewed 01/2018

Appropriately used, local anaesthesia can give complete analgesia in a wide variety of clinical situations with minimal drawbacks. Particular indications include:

  • painful procedures, e.g. chest drains
  • intra- and postoperative analgesia
  • analgesia after trauma
  • infants with respiratory disease who are unable to tolerate large doses of opioid

Local anaesthesia may take several forms:

  • surface anaesthesia:
    • indicated, e.g. for trauma such as repeated heel pricks
    • EMLA cream is applied sparingly every 4 hours
    • in children over a year, the cream is applied thickly and left under an occlusive dressing
  • local infiltration:
    • e.g. peripheral nerve or regional block
    • used to enhance analgesia during surgery
    • central extradural block can be administered by an experienced team