ABSTRACT
Local anesthetics have revolutionized surgery and many more medical subspecialties. The first local anesthetic ever used was cocaine, which remained for many years the only active substance and also the standard until procaine was synthesized. Local anesthetics are used for surface, infiltration, regional and plexus blocks, epidural, and intrathecal anesthesias. The aim of local anesthesia is to make the skin and mucous membranes, as well as deeper tissues, insensitive to pain. Topical anesthetics are a help for venipuncture, vaccinations, some very superficial procedures, such as curettage, shave excisions, and laser treatments, and a variety of other procedures. Topical anesthetics have gained wide acceptance in dermatologic surgery, but also in pediatrics and wherever there is unbalanced fear of a needle prick. Lidocaine is certainly the most commonly used local anesthetic in dermatologic surgery and has an excellent safety report. Etidocaine is a long-acting local anesthetic that is well tolerated not only for nerve blocks but also for infiltration anesthesia.
