Perioperative Use of Local Anesthetics and Adjuvants

Local anestheticsLocal anesthetic have long been a key element in the surgeon and anesthesiologist’s perioperative analgesiaPerioperative analgesia strategy. The unique pharmacological attributes of this class of medications provides the ability to interrupt the transmission of nociceptive insults at multiple sites in the peripheral and central nervous system. However, this therapeutic class also requires caution to avoid catastrophic toxicity syndromes. Various additives and adjunct therapies can greatly extend local anestheticLocal anesthetic duration of action, but their use requires careful consideration to safely and effectively implement into clinical practice. Recent innovations have sought to further extend the duration of local anestheticsLocal anesthetic through novel formulations, but safety, cost, and efficacy concerns may limit the applicability of these agents.