Comments on “Local Anesthetic Systemic Toxicity”

We read with interest the article by Dickerson and Apfelbaum entitled “Local Anesthetic Systemic Toxicity.”1 The local anesthetics in clinical practice today are of 2 classes: amino esters and amino amides.2,3 These 2 classes differ not only in chemical structure but also in metabolism and potential for allergic reaction and toxicity.2 Esters include cocaine, procaine, 2-chloroprocaine, tetracaine, and benzocaine. …