Complications Adverse reaction to the anesthetic (eg, allergic reaction to the anesthetic [rare] or to methylparaben [a preservative]) Toxicity due to anesthetic overdose (eg, seizure, cardiac arrhythmias) or sympathomimetic effects due to epinephrine Intravascular injection of anesthetic / epinephrine Hematoma Spread of infection, by passing the needle through an infected area Equipment Nonsterile gloves Barrier precautions as indicated (eg, face mask, safety glasses or face shield, cap and gown) Antiseptic solution (eg, chlorhexidine, povidone-iodine, alcohol) Syringe (eg, 1 to 10 mL) and needle (eg, 25 or 27 gauge) for anesthetic injection Injectable local anesthetic * (eg, 1% lidocaine † with or without epinephrine ‡ 1: 100, 000, 25-gauge needle) Topical anesthetic§ (eg, LET solution: 4% l idocaine, 0.1% e pinephrine, 0.5% t etracaine) plus cotton ball or dental pledget; optional and often used for children Tissue forceps (eg, Adson forceps), tissue hook as needed to expose the sides of the wound #11 scalpel blade for tissue undermining and debridement (if needed) * Local anesthetics are discussed in Lacerations.