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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.
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 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...

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Related Experiment Video

Updated: Jul 9, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Instrumentation for epidural anesthesia.

King-Wei Hor¹, Denis Tran, Allaudin Kamani

¹Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada. kingh@ece.ubc.ca

Medical Image Computing and Computer-Assisted Intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention

|November 30, 2007

Summary

A new device quantifies epidural anesthesia loss-of-resistance, confirming its consistency with anesthesiologist feedback. This technology simplifies pressure measurement, aiding studies on ligamentum flavum and interspinous ligament resistance.

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Area of Science:

Anesthesiology and Medical Instrumentation

Background:

The loss-of-resistance technique is crucial for epidural anesthesia placement.
Quantifying this technique objectively can improve safety and efficacy.

Purpose of the Study:

To develop and validate a low-cost, sterilizable device for quantifying the loss-of-resistance technique.
To compare the mechanical properties of the ligamentum flavum and interspinous ligament during saline injection.

Main Methods:

A novel instrumentation device was designed to measure applied force and plunger displacement.
A fluid leakage model was developed to estimate pressure, obviating the need for a pressure sensor in human studies.
Porcine (in vitro) and human (in vivo) studies were conducted to validate the device and assess ligament resistance.

Main Results:

The device accurately quantified rapid force drops, plunger displacement, and fluid pressure, correlating with anesthesiologist-reported loss-of-resistance.
The developed model effectively estimated pressure from force and displacement data.
Both human and porcine subjects demonstrated that the ligamentum flavum offers greater resistance to saline injection than the interspinous ligament.

Conclusions:

The developed instrumentation provides a reliable and cost-effective method for studying the loss-of-resistance technique.
The findings offer insights into the differential mechanical behavior of spinal ligaments, relevant for epidural procedures.
The simplified pressure estimation model facilitates broader application in clinical research.