Episode 41: Local Anesthetics

Local anesthetics and their mechanisms are the focus of this episode, beginning with how these agents block nerve conduction by blocking sodium channels. The discussion covers the two classes of local anesthetics, amino amides and amino esters, detailing their metabolism, stability, and likelihood of causing allergic reactions. The episode further explores the relationship between a drug's pKa and its onset of action, noting lidocaine's rapid onset due to its low pKa. Additionally, the conversation includes toxicity, from initial CNS symptoms to cardiovascular effects, and emphasizes the importance of having lipid emulsion available. Common blocks are reviewed, along with the types and doses of anesthetics used.