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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 Surface, Infiltration, and Conduction Block Anesthesia01:30

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 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...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:

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Related Experiment Video

Updated: Jul 17, 2026

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
08:50

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Published on: June 25, 2013

Local posterior perianal block for proctologic surgery.

Stylianos Delikoukos1, Dimitrios Zacharoulis, Constantine Hatzitheofilou

  • 1Department of Surgery, Larissa University Hospital, Larissa, Greece. morfula@otenet.gr

International Surgery
|January 30, 2007
PubMed
Summary

Local posterior perianal block (LPPB) offers a safe and effective anesthesia option for various proctologic surgeries. Most patients experienced pain relief and high satisfaction, indicating LPPB

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Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
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Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis

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Published on: October 17, 2025

Area of Science:

  • Colorectal Surgery
  • Anesthesiology
  • Pain Management

Background:

  • Proctologic surgeries often require effective anesthesia.
  • Local posterior perianal block (LPPB) is a regional anesthesia technique.

Purpose of the Study:

  • To evaluate the efficacy and safety of LPPB in proctologic operations.
  • To assess short- and medium-term outcomes of LPPB.

Main Methods:

  • Retrospective analysis of 72 patients undergoing proctologic surgery under LPPB.
  • Procedures included hemorrhoidectomy, fistula resection, abscess revision, and tumor electrocoagulation.
  • Data collected on anesthesia, complications, pain scores (VAS), and patient satisfaction.

Main Results:

  • Nearly all patients were pain-free during surgery.
  • Postoperative pain scores (VAS) ranged from 1.6 to 3.4 within 24 hours.
  • High patient satisfaction (mean VAS 8.6) and willingness to repeat the procedure (97.2%) were reported.

Conclusions:

  • LPPB is a safe and widely applicable anesthetic technique for proctologic surgery.
  • The technique provides effective pain control and high patient satisfaction.
  • LPPB is a viable alternative for various anal procedures.