ABSTRACT
Before infiltrative anesthesia could be performed effectively, an appropriate delivery device had to be invented and an effective local anesthetic had to be isolated. Interestingly, it was the ancient Javanese practice of using darts to deliver poison that provided the first experimental model for subcutaneous infiltration. Infiltrative anesthesia is the intradermal or subcutaneous infiltration of an anesthetic either directly into the surgical site or circumferentially around the surgical field. Infiltration of an anesthetic directly below a lesion creates a small ring of anesthesia around its base that is sufficient to obtain a shave or punch biopsy. The atmosphere in the surgical suite should be calm and soothing. The room should be organized to avoid last-minute running around for instruments and kept at a comfortable temperature. Personnel should be unhurried, courteous, and professional. Local anesthetic solutions exist in water-soluble ionized and lipid-soluble non-ionized form. Alcohol is an excellent agent to cleanse the skin before infiltration of an anesthetic.
