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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...

Local Anesthetics: Clinical Application as Spinal Anesthesia

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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 Anesthesia

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.
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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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.
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Spinal Nerves: Plexus I

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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Spinal Nerves: Plexus II

Spinal Nerves: Plexus II

The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
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Posterior lumbar plexus block: anatomy, approaches, and techniques.

Imad T Awad¹, Edel M Duggan

¹Department of Anesthesia, Toronto Western Hospital, Toronto, Ontario, Canada. imad1000@eircom.net

Regional Anesthesia and Pain Medicine

|March 15, 2005

Summary

The lumbar plexus block is an effective regional anesthesia technique. This review covers its history, anatomy, and updated performance methods for better clinical use.

Area of Science:

Regional anesthesia and pain management.
Anesthesiology and surgical procedures.
Neuroanatomy and clinical application.

Background:

The lumbar plexus block, a regional anesthesia technique, was first described decades ago.
Significant advancements in technology, localization, and imaging have led to modifications of the original technique.
Despite its efficacy, the lumbar plexus block remains underutilized in clinical practice.

Observation:

This review details the historical evolution of the lumbar plexus block.
It provides a comprehensive overview of the relevant lumbar plexus anatomy.
Current and modified techniques for performing the block are described.

Findings:

The lumbar plexus block offers an effective alternative for regional anesthesia.

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Advances in imaging and localization have refined the procedure.

Understanding the anatomy is crucial for successful block performance.

Implications:

Increased awareness and understanding of the lumbar plexus block can improve its clinical adoption.
Refined techniques may enhance safety and efficacy.
This review serves as a guide for practitioners seeking to utilize this regional anesthesia method.