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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 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...

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Related Experiment Video

Updated: Jul 9, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
03:14

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Pain management practices for lumbar punctures: are we consistent?

Jacqueline A Ellis1, Kim Villeneuve, Kym Newhook

  • 1Department of Nursing, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. jellis@uottawa.ca

Journal of Pediatric Nursing
|November 27, 2007
PubMed
Summary

Pediatric patients undergoing lumbar punctures (LPs) receive varied pain management. Oncology patients are consistently sedated, but emergency department patients often are not, highlighting a need for standardized sedation practices.

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Area of Science:

  • Pediatric Medicine
  • Pain Management
  • Anesthesiology

Background:

  • Sedation for lumbar punctures (LPs) is standard in pediatric oncology centers in Canada.
  • The use of sedation for LPs in other hospital units is not well documented.
  • Varied pain management strategies may exist for pediatric LPs across different hospital services.

Purpose of the Study:

  • To audit patient records and understand pain management strategies for LPs in a pediatric hospital.
  • To identify variations in pain management, specifically sedation, for LPs across different hospital units.

Main Methods:

  • A retrospective patient record audit was conducted.
  • The audit included 59 pediatric patients (3 days to 17 years) undergoing 67 LPs.
  • Data on pain management strategies, including sedation, were collected for each LP.

Main Results:

  • Pain management strategies for LPs varied significantly among different patient service units.
  • Pediatric oncology patients consistently received sedation for LPs.
  • Patients in the emergency department were significantly less likely to receive any form of sedation for LPs.

Conclusions:

  • There is inconsistency in pain management for pediatric lumbar punctures across hospital units.
  • Recommendations are needed to ensure consistent, best-practice pain management for LPs.
  • Standardizing sedation practices for LPs could improve patient comfort and care.