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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: 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...

Depolarizing Blockers: Pharmocokinetics

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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...

Skeletal Muscle Relaxants: Therapeutic Uses

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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...

Local Anesthetics: Common Agents and Their Applications

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Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...

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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

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Bupivacaine usage for post-operative bladder spasm.

David Chiang¹, Kelly Pout, David Ben-Meir

¹General Surgical Registrar, Western Health.

Australian Nursing Journal (July 1993)

|January 20, 2009

Summary

Intravesical bupivacaine effectively manages pediatric post-surgical bladder spasms. Most nurses expressed confidence in this novel pain management technique, supporting its continued use for improved patient outcomes.

Area of Science:

Pediatric Surgery
Pain Management
Anesthesiology

Background:

Post-surgical bladder spasms are a common complication in pediatric patients, often leading to inadequate pain control.
Current treatments for bladder spasms, including opioids, sedatives, anticholinergics, and epidural anesthesia, can be effective but frequently result in breakthrough spasms and significant side effects.

Purpose of the Study:

To investigate the experience of nursing staff with intravesical bupivacaine for managing post-operative bladder spasms in children.
To assess the perceived efficacy and confidence levels of nurses regarding intravesical bupivacaine as a treatment option.

Main Methods:

A survey study was conducted among nursing staff at the Royal Children's Hospital, Melbourne.
The survey focused on nurses' experiences and confidence in using intravesical bupivacaine to suppress post-operative bladder spasms.

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Main Results:

A significant majority of nursing staff (89%) reported confidence in intravesical bupivacaine's ability to control bladder spasms.
The nursing staff surveyed expressed support for the continued use of intravesical bupivacaine in clinical practice.

Conclusions:

Intravesical bupivacaine represents a promising new method for managing post-operative bladder spasms in pediatric surgical patients.
Nursing staff confidence and support suggest this intervention is a valuable addition to the pain management armamentarium for pediatric urological surgery.