The Dental Learning Network

Local Anesthetic Review

Chapter One - History of Local Anesthetics


Chapter 2: Neurophysiology

Chapter 3: Pharmacology

Chapter 4: Anesthetic Action

Chapter 5: Uptake, Distribution, and Elimination

Chapter 6: Pharmacology of Vasoconstrictors

Chapter 7: Topical Anesthetics

Chapter 8: Selection of Anesthetics

Chapter 9: Toxicity

Chapter 10: Armamentum

Chapter 11: Patient Evaluation

Chapter 12: Injection Techniques

Chapter 13: Complications

Chapter 14: Other Methods of Anesthesia

Post Examination

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1500's
Accounts referring to Peruvian Indians chewing on leaves of the coca plant are found.
1884 Carl Koller demonstrated the usefulness of the extract from these leaves (cocaine) as a topical anesthetic for the eyes, and earned distinction as the "Father of Local Anesthesia".
1884 William Halsted used cocaine in the first nerve block (an inferior alveolar nerve block). The use of cocaine for anesthesia produced several unwanted side effects including cardiac problems and addiction.
1885 James Corning demonstrated the use of a tourniquet to slow absorption of cocaine.
1901 Heinrich Braun demonstrated the use of epinephrine to retard local anesthetic absorption from the site of injection.
1904 Alfred Einhorn introduced procaine (proprietary name novocaine) which had far fewer side effects. Epinephrine was needed to constrict the vessels in the area of administration to lengthen the duration of anesthesia. It was common to see a 1:50,000 concentration for many years.
1943 Nils Lofgren introduced lidocaine (proprietary name xylocaine), a synthetic anesthetic with far fewer allergic responses and faster onset of action.
1947 Novocol company made the dental aspirating syringe available.
1959 Disposable sterile needles made available by Cook-Waite, Roehr Company.
(Information from: Malamed, 1994: JADA and Yagiela, 1991: Anesthesia Progress)


Continue on to Chapter 2: Neurophysiology