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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 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: Pharmacokinetics01:13

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 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: Common Agents and Their Applications01:23

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 20, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery
05:39

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

Regional anesthesia for vascular access surgery.

Elizabeth B Malinzak1, Tong J Gan

  • 1Department of Anesthesiology, Duke University Medical Center, Duke University School of Medicine, Durham, NC 27710, USA.

Anesthesia and Analgesia
|August 20, 2009
PubMed
Summary
This summary is machine-generated.

Regional blocks improve arteriovenous fistula success by increasing blood flow and vessel size, leading to faster maturation and fewer failures. Further trials are needed to confirm these benefits for vascular access procedures.

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Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats
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Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats

Published on: September 11, 2018

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Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats
06:30

Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats

Published on: September 11, 2018

Area of Science:

  • Vascular Surgery
  • Anesthesiology
  • Nephrology

Background:

  • Arteriovenous fistula (AVF) placement has a 25% failure rate due to thrombosis or inadequate maturation.
  • Successful AVFs depend on vein diameter and blood flow, influenced by patient factors and surgical technique.
  • Anesthetic methods may impact AVF outcomes.

Purpose of the Study:

  • To review the effects of different anesthetic techniques on arteriovenous fistula construction and success.
  • To evaluate the impact of anesthesia on vein dilation, blood flow, and fistula patency.

Main Methods:

  • A literature search was conducted in the PubMed/MEDLINE database.
  • Seven articles focusing on anesthesia's effects on AVF outcomes were selected for review.

Main Results:

  • Regional blocks caused significant vasodilation in cephalic and basilic veins, aiding site selection.
  • Regional anesthesia led to increased intraoperative and postoperative fistula blood flow compared to other methods.
  • Regional blocks resulted in shorter maturation times, lower failure rates, and higher patency rates.

Conclusions:

  • Regional blocks may enhance AVF success through vasodilation, increased blood flow, and reduced maturation time.
  • Sympathectomy-like effects from regional blocks contribute to improved outcomes.
  • Large-scale prospective trials are necessary to validate these findings.