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Related Concept Videos

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 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...
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

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: 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...
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...

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Related Experiment Video

Updated: Jun 20, 2026

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
05:18

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome

Published on: May 26, 2023

Epidural steroid injections and selective nerve root blocks.

Timothy S Eckel1, Walter S Bartynski

  • 1Diagnostic and Interventional Neuroradiology, Annapolis Spine Institute/Annapolis Radiology Associates, Annapolis, MD 21401, USA. teckel@aahs.org

Techniques in Vascular and Interventional Radiology
|September 23, 2009
PubMed
Summary

Image-guided epidural steroid injections and lumbar nerve root blocks offer effective pain relief for various spine conditions. These fundamental procedures provide diagnostic information and sustained pain management for many patients.

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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

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Last Updated: Jun 20, 2026

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
05:18

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome

Published on: May 26, 2023

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

Area of Science:

  • Interventional Pain Management
  • Radiology
  • Neurosurgery

Background:

  • Epidural steroid injections (ESIs) and lumbar nerve root blocks are cornerstone image-guided treatments for spine-related pain.
  • These procedures are essential in managing axial pain, radiculopathy, and spinal stenosis with neurogenic claudication.

Purpose of the Study:

  • To review the clinical indications for epidural steroid injections and lumbar nerve root blocks.
  • To outline the technical approaches for these image-guided spine pain management procedures.

Main Methods:

  • Review of clinical indications and technical approaches for epidural steroid injections and lumbar nerve root blocks.
  • Discussion of imaging guidance techniques including fluoroscopy and computed tomography (CT).

Main Results:

  • Epidural steroid injections are effective for axial pain, radiculopathy, and neurogenic claudication.
  • Transforaminal nerve root blocks offer targeted treatment and diagnostic information for specific nerve root irritation.
  • Both procedures can achieve sustained pain relief in a substantial number of patients.

Conclusions:

  • Epidural steroid injections and lumbar nerve root blocks are fundamental image-guided procedures for spine pain management.
  • Fluoroscopy is a routine approach, with CT/CT fluoroscopy as an alternative or primary method for lumbar procedures.
  • While techniques are similar across regions, cervical, thoracic, and lumbar injections have unique considerations.