Percutaneous Local Anaesthesia

Reporting on a new and important area of anaesthetics and drawing on their own research in the field, the authors provide comprehensive coverage of the technique of percutaneous local anaesthesia. Percutaneous local anaesthesia allows local anaesthetic drugs to penetrate the skin and act on the pain receptors below the skin barrier. The skin is profoundly numbed, removing any pain from injections and allowing minor surgical procedures such as split skin grafting to be performed without use of either general or infiltration anaesthesia. The technique is of particular value in paediatric medicine, minimizing stress and pain to the young patient. Opening with a review of the work undertaken to date in the development of "ideal" percutaneous anaesthetic preparation, and establishing the clinical need, the authors move on to discuss the origins and perceptions of pain, demonstrating how skin pain from surgical intervention arises and how this influences the design of a pain blocking preparation. Various local anaesthetics are examined in detail in order to provide a background for a more detailed exposition on percutaneous delivery. A large part of the book is devoted to how pharmaceutical formulation techniques can be used to achieve skin-barrier penetration by local anaesthetics, and to the applications and benefits of the technique, including the importance of percutaneous local anaesthesia in carrying out such operations as skin grafting.