Local Anesthesia

What is local anesthesia?

Local anesthesia (local anesthetic) is medication healthcare providers use to temporarily numb a small area of your skin, subcutaneous tissue and peripheral nerves before minor procedures. Local anesthetics can also treat some painful conditions and relieve pain after surgery.

Local anesthesia numbs a small section of your body, like a specific area of skin on your arm or part of your gums, for example. It can affect your muscle function, as well, depending on which nerves are targeted. Unlike with general anesthesia, you don’t lose consciousness with local anesthesia. But providers sometimes combine local anesthesia with sedation so you feel relaxed.

Some medications containing mild local anesthetics — like cold sore gels — are also available as prescriptions or over-the-counter products.

Types

Local anesthetics come in many forms depending on their intended purpose, including:

• Creams
• Eye drops
• Gels
• Implants
• Injections
• Ointments
• Skin patches
• Sprays

A few examples of local anesthetics healthcare providers use include:

• Benzocaine
• Bupivacaine
• Cocaine
• Lidocaine
• Ropivacaine with or without mepivacaine
• Tetracaine

Healthcare providers sometimes combine epinephrine or steroids with a local anesthetic to improve safety and make the anesthetic last longer.

How does local anesthesia work?

Local anesthetics work by temporarily blocking your peripheral nerves from sending pain and sensory signals to your brain. They don’t slow down your central nervous system (CNS depression) or cause loss of consciousness.

If the medication works properly, you won’t feel pain in a specific area after having a local anesthetic. But you may still feel some pressure. You’ll also be awake and alert.

How long does local anesthesia last?

Local anesthetics can last from 30 minutes to 12 hours or more. The range depends on factors like:

• The affected area
• The dose
• The type of local anesthetic
• The use of additives like epinephrine or steroids

Your healthcare provider will let you know when to expect the local anesthetic to wear off. Contact your provider if you have numbness or muscle weakness that lasts longer than expected.

When would I need local anesthesia?

Healthcare providers use local anesthesia for a wide range of procedures to block pain. Some examples include:

• Certain eye procedures, like cataract surgery
• Certain orthopedic surgeries, like arthroplasty
• Dental procedures, like filling a cavity (dental filling) or root canals
• Minor biopsies, like a skin or breast biopsy
• Resetting a broken bone
• Stitching a deep cut on your skin
• Minor plastic surgery procedures, like brow lifts, eyelid lifts (blepharoplasties) and lip lifts
• Vaginal delivery or C-section (epidural)

How should I prepare for local anesthesia?

There’s typically nothing you need to do to prepare for local anesthesia, specifically. But you may have certain steps to follow depending on the type of procedure you’re getting. Your healthcare provider will let you know how to prepare.

Let your provider know if you have any allergies or have had issues with anesthetics in the past. If you have a fear of needles (trypanophobia), let them know this, as well.

Can I eat before getting local anesthesia?

For minor procedures, it’s typically fine to eat and drink like usual before getting local anesthesia. But if you’re getting local anesthesia for a procedure that involves your digestive system or bladder, you might have to fast. You may also need to fast if you’re getting a surgery in case your care team needs to switch you to general anesthesia. Your healthcare provider will let you know if this is the case.

General anesthesia almost always requires fasting beforehand.

How is local anesthesia administered?

Because there are several forms of local anesthetics — and reasons for their use — you can receive a local anesthetic in many ways. For example:

• Your dentist may apply a local anesthetic gel to your gums to numb their surface before giving a local anesthetic injection (shot) into your gums (the injection numbs nerves “deeper” into your gums)
• Your provider may use an anesthetic spray for your throat (pharynx) to suppress your gag reflex before an endoscopy
• Your ophthalmologist may apply local anesthetic eye drops before a minor eye surgery
• Your provider may prescribe lidocaine skin patches to relieve the pain of postherpetic neuralgia
• Your provider may inject a local anesthetic around specific nerves to numb an area before orthopedic surgery
• Your provider may insert an epidural catheter to manage pain for vaginal delivery

Many healthcare providers can administer (give) local anesthetics, including:

• Anesthesiologists and nurse anesthetists
• Dentists
• Dermatologists
• Emergency department providers
• Nurse practitioners and physician assistants
• Ophthalmologists
• Primary care providers
• Surgeons

What happens after getting local anesthesia?

After you get local anesthesia, your healthcare provider will check to make sure the area is numb and will then proceed with the procedure you’re getting.

After the procedure, they’ll give you specific instructions for recovery. Be sure to follow them.

Can you drive after local anesthesia?

In most cases, you should be able to drive after getting local anesthesia, like if you got it for a dental procedure or biopsy. If the procedure you had affects your ability to use your hands, foot or eyes, you might not be able to drive afterwards.

If you received sedation alongside local anesthesia, you’ll need someone else to drive you home.

What are the benefits of local anesthesia?

Local anesthetics allow healthcare providers to do many surgical procedures with less preparation and shorter recovery times.

Local anesthesia is also generally safer than general anesthesia. It typically has fewer and less severe side effects than general anesthesia.

What are the side effects of local anesthesia?

Local anesthesia side effects are rare and usually minor. If you had an anesthetic injection, you may experience some soreness and/or bruising where it was injected. Some people experience other temporary side effects from local anesthesia, like:

• Dizziness
• Headaches
• Blurred vision
• Muscle twitches
• Persistent numbness, weakness or a pins and needles sensation

What are the possible complications of local anesthesia?

It’s very rare, but some people have an allergic reaction to local anesthetics. If it happens, it typically develops soon after the application, so your healthcare provider will be able to treat it quickly.

Another rare complication is local anesthetic systemic toxicity (LAST). If it happens, it typically develops within one to five minutes of a local anesthetic injection. Symptoms include:

• Agitation
• Confusion
• Dizziness
• Drowsiness
• Hearing changes
• Metallic taste
• Slurred speech (dysarthria)

LAST is treatable. But without proper treatment, it can progress to seizures, heart issues, respiratory arrest and/or coma.

How long does it take to recover from local anesthesia?

It may take time to regain sensation after you get a local anesthetic for a procedure. And it could temporarily affect some of your abilities. This varies greatly depending on the type of anesthetic you got and the procedure.

For example, if you received local anesthesia for a dental procedure, it might be difficult to speak clearly or eat for up to seven hours afterward. You might have a hard time keeping saliva inside your mouth, too. It’s also a good idea to avoid eating with the side of your mouth affected by the anesthetic — you could bite the inside of your cheek or hurt your gums and not realize it.

Your healthcare provider will let you know what to expect for recovery.

When should I call my healthcare provider?

Call your healthcare provider if you experience prolonged side effects from local anesthesia or any issues related to the procedure you had.

Is local anesthesia safe during pregnancy?

Local anesthesia is generally safe during pregnancy. But it’s always a good idea to check with your healthcare provider before getting it for a procedure.

Are you awake during local anesthesia?

Yes, you’re alert and awake if you’re just getting local anesthesia. It doesn’t affect your level of consciousness.