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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: 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...

Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Pharmacokinetics in Pediatric Patients: Drug Distribution

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...

Local Anesthetics: Adverse Effects

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...

General Anesthesia: Overview

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...

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Related Experiment Video

Updated: Jul 8, 2026

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Published on: July 30, 2009

[Risks and dangers in pediatric regional anesthesia].

R Hillmann¹, F-J Kretz

¹Klinik für Anästhesiologie und operative Intensivmedizin, Olgahospital, Pädiatrisches Zentrum, Klinikum Stuttgart, Bismarckstr. 8, 70176 Stuttgart. r.hillmann@klinikum-stuttgart.de

Der Anaesthesist

|January 23, 2008

Summary

Pediatric regional anesthesia, including central and peripheral nerve blocks, is crucial and safe for children. Understanding pediatric specifics and using ultrasound minimizes complications, making these techniques essential.

Related Experiment Videos

Last Updated: Jul 8, 2026

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure

Published on: July 30, 2009

Area of Science:

Pediatric Anesthesiology
Regional Anesthesia Techniques
Ultrasound-Guided Procedures

Context:

Regional anesthesia is increasingly vital in pediatric anesthesia care.
Children often receive regional anesthesia under general anesthesia.
Specialized knowledge of pediatric anatomy, physiology, and pharmacokinetics is essential.

Purpose:

To highlight the importance and safety of pediatric regional anesthesia.
To discuss the necessary considerations for safe practice in children.
To review potential complications associated with these procedures.

Summary:

Peripheral and central regional anesthesia are safe and beneficial for pediatric patients.
Complications are rare when anatomical, physiological, and pharmacokinetic characteristics are considered.
Ultrasound guidance further enhances the safety of pediatric regional anesthesia.

Impact:

Ensures pediatric patients benefit from safe and effective regional anesthesia.
Provides guidance for anesthesiologists to minimize risks.
Supports the continued integration of advanced regional anesthesia techniques in pediatric care.