Local Anesthetics

Alex Sailon, MD

Content Contributor

Evolution of Local Anesthetics

There are many different types of local anesthetics. Lidocaine and bupivacaine are among the most commonly used. The medications differ primarily in the speed at which they cause numbness and how long their effect remains. Although topical formulations of local anesthetic exist (such as “numbing creams”), they typically do not have a role in reducing post-surgical pain.

Local anesthetic must be administered by a medical professional. Doses are calculated carefully based on body weight. Although generally extremely safe, local anesthetics do have the potential for side effects, just like any medication. Allergic reactions and permanent nerve damage are possible but very rare. In the overwhelming majority of people, sensation and muscle function return to normal once the anesthetic has worn off.

Technology Spotlight

Exparel

Exparel© is a unique technology that allows for the local anesthetic pain-relieving effect to last 2-3 days. This is significantly longer than the 6-8 hours provided by traditionally available local anesthetics. Bupivicaine (the local anesthetic used in Exparel©) is suspended in small lipid particles that break down over 2-3 days, causing a continuous, gradual release of the pain-relieving medicine.

Studies done in surgical patients receiving Exparel© show a dramatic reduction in opioid (narcotic) use and significantly better pain control. This improved postsurgical pain may also result in more mobility after surgery, less risk of complications, and an overall faster recovery. Exparel© has also proven to be as safe as, if not safer, than traditional local anesthetics. Studies show no detrimental effect on wound healing.