Local anesthetics are used extensively on the mucous membranes in the nose, mouth, tracheobronchial tree, and urethra. The vasoconstriction produced by some local anesthetics, cocaine especially, adds a very important advantage to their use in the nose by preventing bleeding and inducing tissue shrinkage. Topical anesthesia permits many diagnostic procedures in the awake patient, and when it is combined with infiltration techniques, excellent anesthesia may be obtained for many surgical procedures in the eye and nose. The practitioner should be cautious when higher volumes are required, since overdosage may cause systemic reactions. Additionally, when the tracheobronchial tree and larynx are anesthetized, normal protective reflexes, which prevent pulmonary aspiration of oral or gastric fluids and contents, are lost.
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