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Local Anesthetics: Clinical Application as Spinal Anesthesia

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 Intravenous Regional Anesthesia

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 Fibers

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...

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Related Experiment Video

Updated: Jul 8, 2026

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

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

Published on: October 17, 2025

Cervical foraminal selective nerve root block: a 'two-needle technique' with results.

Naresh Kumar¹, Veda Gowda

¹New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, WV10 0QP, UK. naresh@doctors.org.uk

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|January 22, 2008

Summary

A novel two-needle technique for cervical selective nerve root block offers a safe and effective non-surgical treatment for radiculopathy. This method significantly improved pain and disability scores in patients with cervical disc disease or foraminal stenosis.

Related Experiment Videos

Last Updated: Jul 8, 2026

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

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

Published on: October 17, 2025

Area of Science:

Interventional Pain Management
Neurosurgery
Radiology

Background:

Cervical radiculopathy, often caused by disc disease or foraminal stenosis, significantly impacts patient quality of life.
Various techniques exist for selective nerve root blocks, but novel approaches are continually sought for improved efficacy and safety.

Purpose of the Study:

To evaluate the effectiveness and safety of a newly developed 'two-needle technique' for cervical selective nerve root blocks in treating radiculopathy.
To assess patient outcomes using Visual Analogue Score (VAS) and Neck Disability Index (NDI) following the procedure.

Main Methods:

A retrospective study involving 33 patients with cervical radiculopathy undergoing the 'two-needle technique' under C-arm guidance.
Exclusion criteria included myelopathy and gross motor weakness.
Outcome measures (VAS and NDI) were compared pre-procedure and at 6 weeks and 12 months post-procedure.

Main Results:

Statistically significant improvements were observed in both VAS and NDI scores at 6 weeks and 12 months post-procedure.
Average VAS decreased from 7.4 to 2.0, and NDI decreased from 66.9 to 31.1 at 1 year.
Patients with C6 or C7 nerve root involvement showed slightly better VAS improvement at 6 weeks. Minor complications like transient dizziness and nystagmus were reported.

Conclusions:

The 'two-needle technique' is a safe, effective, and minimally invasive non-surgical option for managing cervical radiculopathy.
This technique demonstrates significant potential for pain reduction and functional improvement in patients with cervical disc disease and foraminal stenosis.