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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: 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...

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.

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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...

Stages of General Anesthesia

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...

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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Updated: Jun 21, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

[Epidural anesthesia in labor and conversion disorder].

M Díaz Allegue¹, S González Bardanca, O Pato López

¹Servicio de Anestesiología y Reanimación, Hospital Universitario Juan Canalejo, A Coruña. kralove@hotmail.com

Revista Espanola De Anestesiologia Y Reanimacion

|July 8, 2009

Summary

Conversion disorder, a psychiatric condition, can manifest with neurological symptoms like foot numbness during labor. This often underdiagnosed condition requires careful medical evaluation to distinguish from organic causes.

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Last Updated: Jun 21, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Area of Science:

Neurology
Psychiatry
Obstetrics

Background:

Conversion disorder is a psychiatric condition characterized by neurological symptoms suggestive of organic disease.
It is often underdiagnosed despite a high incidence in the general population.
This case highlights the presentation of conversion disorder in a patient during labor.

Observation:

A 37-year-old woman in labor presented with new-onset dorsal foot numbness and difficulty with dorsal flexion.
She had a past psychiatric history of depression and attempted suicide.
Organic causes for the neurological symptoms were ruled out by medical evaluation.

Findings:

A diagnosis of conversion disorder was considered after excluding organic etiologies.
The patient's symptoms were not feigned and could not be attributed to a medical condition, substance, or culturally normal behavior.
Conversion disorder can lead to significant clinical, social, and occupational impairment.

Implications:

This case underscores the importance of considering psychiatric diagnoses, such as conversion disorder, in patients presenting with neurological symptoms during labor.
Early recognition and diagnosis of conversion disorder are crucial for appropriate management and to prevent unnecessary medical interventions.
Further research is needed to understand the prevalence and specific triggers of conversion disorder in obstetric populations.