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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...
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 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...
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
Parenteral Anesthetics: Overview01:24

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.

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Updated: Jul 5, 2026

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

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Shivering and neuraxial anesthesia.

Larry J Crowley1, Donal J Buggy

  • 1Department of Anesthesia, Intensive Care & Pain Medicine, Mater Misericordiae University Hospital, Dublin, Republic of Ireland. larryjcrowley@gmail.com

Regional Anesthesia and Pain Medicine
|April 25, 2008
PubMed
Summary

Post-anesthesia shivering is common, affecting 55% of patients. This review explores its causes, physiological stress, and effective prevention and treatment strategies for neuraxial anesthesia patients.

Area of Science:

  • Anesthesiology
  • Physiology
  • Thermophysiology

Background:

  • Shivering is a thermoregulatory response to cold.
  • Post-anesthesia shivering can occur after general or neuraxial anesthesia.
  • While shivering aids thermoregulation, it increases physiological stress.

Purpose of the Study:

  • To elucidate the mechanisms of shivering during neuraxial anesthesia.
  • To examine prevention and treatment strategies for post-neuraxial anesthesia shivering.

Main Methods:

  • Systematic review of 21 studies.
  • Analysis of shivering incidence in control groups.
  • Evaluation of pharmacological and non-pharmacological interventions.

Main Results:

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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Laminectomy and Spinal Cord Window Implantation in the Mouse
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Laminectomy and Spinal Cord Window Implantation in the Mouse

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  • Median incidence of shivering related to neuraxial anesthesia was 55% in control groups.
  • Both pharmacological and non-pharmacological methods are effective in reducing shivering.
  • Specific causative factors differ between general and neuraxial anesthesia.

Conclusions:

  • Neuraxial anesthesia is frequently associated with shivering.
  • Understanding mechanisms is key to effective management.
  • Evidence supports various strategies for prevention and treatment.