• How does the sensitivity for blockade by a LA compare regarding the following types of fibers:

(a) myelinated fibers with unmyelinated fibers; and

(b) pressure/touch nerves with the dorsal nerves that transmit pain impulses?

a.  The smaller and myelinated fibers are blocked much easier in comparison to the larger, unmyelinated fibers which are much less sensitive to blockade by the local anesthetics.

b.  Activated pain fibers fire rapidly, thus pain sensation may be selectively blocked by local anesthetics. Fibers that are located in the periphery of nerve thick nerve bundles are blocked sooner than the fibers located in the core of thick nerve bundles. This is because they are exposed too higher concentrations of the anesthetic much earlier.

• Make a list of the effects of LA on other tissues.

Heart: Local anaesthetics have Class I anti-arrhythmic drug effects resulting in cardiac depression

Skeletal muscle: Weak blocking effects, no clinical application.

• What is the basis for the selection of a LA?

A local anesthetic is chosen due to the following factors:

• • The type of procedure that is being done
  • The type of tissue that the local anesthetic should be used on
  • The duration of the numbing effect that is needed

• Why are LA solutions sometimes saturated with CO₂?

The Carbon Dioxide acts as a buffer to the Local Anesthetic. This will potentiate the effects of the local anesthetic.

• Which of the LA are typically used for surface anesthesia?
  • Benzocaine
  • Cocaine
  • Oxybuprocaine