Onset and duration of action of local anesthetics are influenced by several factors. These include tissue pH, pKa of the drug, nerve morphology, concentration, and lipid solubility of the drug. Of these, the most important are pH of the tissue and pKa of the drug. At physiologic pH, these compounds are charged. The ionized form interacts with the protein receptor of the sodium channel to inhibit its function and, thereby, achieve local anesthesia. The pH may drop in sites of infection, which causes onset to be delayed or even prevented. Within limits, higher concentration and greater lipid solubility improve onset to some degree. Duration of action depends on the length of time the drug can stay in the nerve to block sodium channels.