Local anesthetics: uses and toxicities.

Surgeons are asked to do more and larger procedures as outpatient procedures as the economics of medicine evolve. Indeed, we all carry out procedures on an outpatient basis that only a short time ago we would consider only on an inpatient basis. Further, procedures that had previously been performed under a general anesthetic are now being performed under local anesthesia. A good working knowledge of local anesthetics (LAs) will better enable the surgeon to meet those demands and to do so in a way that will enhance the patient's safety, experience, and comfort. Although the focus of this issue of Clinics is minor surgery, any meaningful discussion of LAs has to go a little further than a 3-mL syringe and a small amount of lidocaine.