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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...

Local Anesthetics: Pharmacokinetics

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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: 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: Common Agents and Their Applications

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
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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Related Experiment Video

Updated: Jun 24, 2026

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Published on: June 25, 2013

Anesthesia considerations in large-volume lipoplasty.

Mohan Thomas¹, Nitin Bhorkar, James D'Silva

¹Cosmetic Surgery Institute, 169, Lilly Villa, St. Andrews Road, off Turner Road, Bandra West, Mumbai, Maharashra, India. cosmodoc1@yahoo.co.in

Aesthetic Surgery Journal

|April 4, 2009

Summary

General anesthesia for large-volume lipoplasty is safe and effective. Following specific anesthetic and perioperative protocols enhances patient recovery, minimizing complications for this increasingly common cosmetic procedure.

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Area of Science:

Plastic Surgery
Anesthesiology
Perioperative Medicine

Background:

Large-volume lipoplasty is a common and safe procedure.
General anesthesia is typically used for large-volume lipoplasty.
Anesthesia and fluid management are critical for safety.

Purpose of the Study:

To present a protocol for general anesthesia in large-volume lipoplasty.
To highlight key considerations for improved perioperative outcomes.

Main Methods:

32 patients underwent large-volume lipoplasty (5-18.5 L) under general endotracheal anesthesia.
Key strategies included patient selection, low gas flow, hypothermia prevention, DVT prophylaxis, specific fluid ratios, and Foley catheter use.
Endotracheal cuff pressure management and lidocaine in wetting solution were employed.

Main Results:

No major complications occurred in any patients.
Minor complications (nausea, vomiting, shivering) affected approximately 25% of patients.
All patients ambulated independently within 4 hours, reporting better-than-expected recovery.

Conclusions:

General anesthesia for large-volume lipoplasty is a safe procedure.
Adherence to recommended anesthetic and perioperative protocols can expedite and improve patient recovery.