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Local anaesthetics

Cocaine is an alkaloid extracted from cocoa leaves and was the first local anaesthetic (LA) used. It is an effective anaesthetic agent with additional vasoconstriction that is useful in certain situations, but significant side effects, such as euphoria and addiction, limit its medical use essentially to operative preparation for treatment of the nose and throat. Procaine (Novocain) was a synthetic analogue (1905) that did not have the same problems with addiction but had other significant problems of its own-it had a weak action, it took a long time to work and was short acting. Furthermore, a high frequency of allergic reactions (up to 33%) means that it is no longer in common use.