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Related Concept Videos

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: 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: 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...
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...
Spinal Nerves: Plexus II01:21

Spinal Nerves: Plexus II

The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...

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Updated: Jul 5, 2026

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
08:05

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Published on: November 21, 2025

Lower extremity regional anesthesia with the low sciatic nerve block.

Keith Goss1

  • 1Department of Surgery, Northern Navajo Medical Center, Indian Health Service, Shiprock, NM, USA. keith.goss@ihs.gov <keith.goss@ihs.gov>

Clinics in Podiatric Medicine and Surgery
|May 20, 2008
PubMed
Summary

Regional anesthesia effectively manages pain after lower extremity orthopedic surgery, reducing narcotic use and complications. This review focuses on local anesthetic mechanisms and the low sciatic nerve block technique.

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Area of Science:

  • Anesthesiology
  • Orthopedic Surgery
  • Pain Management

Background:

  • Regional anesthesia is crucial for perioperative pain control in lower extremity orthopedic procedures.
  • Local anesthetics offer effective pain relief and reduce opioid dependency.
  • Minimizing surgical morbidity is a key goal in orthopedic patient care.

Purpose of the Study:

  • To review the mechanisms of local anesthetic agents in acute surgical pain.
  • To emphasize the low sciatic nerve block as a regional anesthesia technique.
  • To discuss administration techniques and clinical experience with the low sciatic nerve block.

Main Methods:

  • Literature review on local anesthetic mechanisms and regional anesthesia.
  • Focus on the low sciatic nerve block for lower extremity surgery.
  • Discussion of author's clinical experience and administration techniques.

Main Results:

  • Regional anesthesia techniques are consistent and effective for pain management.
  • Local anesthetics significantly minimize postoperative pain and reduce narcotic usage.
  • These anesthetic methods contribute to reducing morbidity associated with lower extremity surgery.

Conclusions:

  • The low sciatic nerve block is an important regional anesthesia technique for lower extremity orthopedic surgery.
  • Understanding local anesthetic mechanisms enhances pain management strategies.
  • Effective regional anesthesia improves patient outcomes by reducing pain and complications.