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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 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...
Parenteral Anesthetics: Overview01:24

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: 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...

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Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
09:47

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery

Published on: June 2, 2022

Pediatric regional anesthesia.

G Ivani1, V Mosseti

  • 1Division of Pediatric Anesthesiology and Intensive Care Unit, Regina Margherita Children's Hospital, Turin, Italy. gioivani@libero.it

Minerva Anestesiologica
|October 3, 2009
PubMed
Summary
This summary is machine-generated.

Pediatric regional anesthesia is safe and effective, with ultrasound guidance improving outcomes like success rates and block duration. However, further research is needed to fully establish its safety advantages over traditional methods in children.

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Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Medical Imaging

Background:

  • Pediatric regional anesthesia has evolved significantly, becoming a widely adopted technique internationally due to its efficacy and safety.
  • Advancements in anesthetic drugs and dedicated pediatric tools have been crucial to its success.
  • Despite benefits, clinical failures can occur due to anatomical variability and limitations of traditional nerve localization techniques.

Purpose of the Study:

  • To evaluate the efficacy and safety of ultrasound guidance in pediatric regional anesthesia.
  • To compare ultrasound-guided techniques with traditional nerve stimulation methods in children.
  • To highlight the benefits and limitations of real-time ultrasound guidance in pediatric procedures.

Main Methods:

  • Review of international literature on pediatric regional anesthesia.
  • Analysis of studies comparing ultrasound guidance with traditional nerve stimulation.
  • Examination of data on block characteristics, success rates, and safety outcomes.

Main Results:

  • Ultrasound guidance in children improves block characteristics, including shorter performance time, higher success rates, and longer block duration.
  • It also reduces the required volume of local anesthetic and enhances visualization of neuraxial structures.
  • While effective, the safety advantage of ultrasound over traditional methods has not been definitively proven in all pediatric blocks, with limited randomized controlled trials.

Conclusions:

  • Ultrasound guidance offers significant advantages for pediatric regional anesthesia, enhancing efficacy and procedural efficiency.
  • Further research, particularly randomized controlled trials, is necessary to fully demonstrate the safety benefits of ultrasound guidance in pediatric populations.
  • Standardized training and practice guidelines are essential for optimizing the use of ultrasound in pediatric regional anesthesia.