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Related Concept Videos

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...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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...
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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...

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Related Experiment Video

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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
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[Paresthesia in various spinal anesthesia techniques for cesarean section].

F Palacio Abizanda1, M A Reina, I Fornet Ruiz

  • 1Departamento de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid. pacopalacio@terra.es

Revista Espanola De Anestesiologia Y Reanimacion
|December 19, 2007
PubMed
Summary

Combined epidural-subarachnoid puncture techniques increase the risk of paresthesia during spinal anesthesia. Slow, steady subarachnoid puncture with careful introducer needle withdrawal minimizes paresthesia incidence.

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Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Obstetrics

Context:

  • Spinal anesthesia is frequently used for cesarean sections.
  • Paresthesia is a known complication of spinal puncture.
  • Minimizing paresthesia is crucial for patient safety and procedural success.

Purpose:

  • To compare the incidence of paresthesia across four different spinal puncture techniques.
  • To evaluate the role of combined epidural-subarachnoid puncture versus simple subarachnoid puncture.
  • To assess the impact of introducer needle use and withdrawal on paresthesia.

Summary:

  • A prospective trial randomized 224 patients undergoing cesarean section into four groups based on spinal puncture technique.
  • Paresthesia incidence was highest in combined epidural-subarachnoid techniques (23% and 11%) compared to simple subarachnoid puncture (16% and 5%).
  • Risk of paresthesia was significantly greater with combined techniques, particularly when the dural sac was deformed by an epidural needle.

Impact:

  • Findings suggest combined epidural-subarachnoid puncture increases paresthesia risk due to dural sac deformation.
  • Slow, deliberate subarachnoid puncture with pre-withdrawal of the introducer needle is associated with fewer paresthesia events.
  • These results can inform procedural modifications to enhance patient safety during spinal anesthesia.