ABSTRACT
Topical anesthetics have become more and more important in dermatologic surgery. Their importance has grown with the recent evolution in laser surgery and surgical procedures. The amide anesthetics have an amide linkage between the aromatic ring and the intermediate chain. The target for cutaneous analgesia is the dermis since it contains free nerve endings and blood vessels. Topical anesthetic inhibits the sodium influx of sodium channels of the nerve synaps, thereby increasing the threshold for nerve excitation until the inability to produce an action potential. Eutectic Mixture of Local Anesthetics (EMLA) must be applied under an occlusive dressing to facilitate the absorption in the skin. EMLA is ineffective on palmar and plantar surfaces due to the thickened stratum comeum. Topical anesthetics are a new advance for pain relief prior to dermatological procedures. It decreases the anxiety of the patients, especially the children, since there is no longer the need for anesthetic injections.
