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Related Concept Videos

Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.

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Guidelines for Elective Pediatric Fiberoptic Intubation
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Ropivacaine with or without clonidine improves pediatric tonsillectomy pain.

C Giannoni1, S White, F K Enneking

  • 1Department of Otolaryngology, Baylor College of Medicine, Houston, TX 77030, USA. cmgianno@texaschildrenshospital.org

Archives of Otolaryngology--Head & Neck Surgery
|November 1, 2001
PubMed
Summary

Preemptive analgesia with ropivacaine and clonidine significantly reduced pain and opioid use after tonsillectomy in children. This approach also accelerated recovery and decreased ear pain, improving the overall patient experience.

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Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Tonsillectomy is a common pediatric surgical procedure associated with significant postoperative pain.
  • Effective pain management is crucial for hastening recovery and improving patient outcomes after tonsillectomy.

Purpose of the Study:

  • To evaluate the preemptive analgesic effects of ropivacaine hydrochloride with or without clonidine hydrochloride on pain and recovery after pediatric tonsillectomy.

Main Methods:

  • A prospective, randomized, triple-blinded trial was conducted with 64 children aged 3 to 15 years undergoing tonsillectomy.
  • Participants received preincisional injections in the tonsillar fossae with either isotonic sodium chloride, ropivacaine, or ropivacaine plus clonidine.
  • Pain scores, opioid consumption, recovery time, and incidence of otalgia were assessed.

Main Results:

  • Ropivacaine and ropivacaine plus clonidine significantly reduced postoperative pain on day 0 compared to the control group.
  • The ropivacaine plus clonidine group showed decreased pain on postoperative days 3 and 5.
  • Opioid use was reduced on postoperative day 0, and cumulative codeine use was lower at day 5 in the ropivacaine plus clonidine group.
  • The incidence of otalgia decreased, and recovery to normal activity was significantly shortened in the ropivacaine plus clonidine group.

Conclusions:

  • Preincisional administration of ropivacaine with clonidine provides effective preemptive analgesia following tonsillectomy.
  • This combined approach offers prolonged pain relief, reduced opioid requirements, and faster return to normal activities in pediatric patients.