Can a tooth be extracted without novocaine?

I have a strong aversion to novocaine because I hate the fat lip/numb feeling.

I have had a deep filling done without novocaine and was curious, how much worse is an extraction? If I can handle a deep filling, can a tooth (particularly a molar) be pulled without novocaine?
Update: Or can you be put to sleep for an extraction instead with general anesthesia?
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