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Here's a little explanation I got from U world while doing the questions:

"Areas of infection typically produce an acidic environment. Local anesthetics such as lidocaine are basic compounds, and can become neutralized in infectious acidic environments such that they are rendered ineffective. If this patient's cellulitis progresses to abscess formation, a local anesthetic should be used to anesthetize the epidermis in order to drain the abscess".

So what does this really mean? Is it saying that for cellulitis, local anesthetics are ineffective in reducing pain but in abscess, they are effective in reducing pain? Can someone please clarify?

I am guessing because an abscess is a localized purulent state where the body is trying to heal itself and containing the infection and so a local anesthetic would work on the pain since its localized.

However in cellulitis, its still an ongoing active process and a local anesthetic won't work because it will spread out throughout the tissue and the acidic environment would just neutralize it?

i think he just mentioned that not to compare abscess treatment vs cellulitis treatment...

they are just suggesting to drain the abscess if it develops from cellulitis using regular protcol which involves anesthetizing the skin before Incision and drainage of an abscess.. He is not suggest use lidocaine to treat an abscess...

Standalone treatment with anesthetics won't work on local infections due to acidic nature, doesn't matter whether its abscess or cellulitis.

Ok that makes sense. Thanks!