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Related Concept Videos

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...
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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 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...
Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
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.

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Related Experiment Video

Updated: Jun 17, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
03:14

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Optimizing epidural fentanyl loading dose for early labor pain.

Feng-Fang Tsai1, Gong-Jhe Wu, Chen-Jung Lin

  • 1Department of Anesthesiology, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.

Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists
|December 18, 2009
PubMed
Summary

Adding fentanyl to epidural bupivacaine significantly improved labor pain relief. Higher fentanyl doses provided greater pain coverage and reduced the need for supplemental analgesia during early labor.

Related Experiment Videos

Last Updated: Jun 17, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
03:14

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Area of Science:

  • Anesthesiology
  • Obstetrics
  • Pain Management

Background:

  • Effective visceral pain relief during early labor requires sensory blockade between T10 and L1.
  • Epidural analgesia is commonly used for labor pain management.

Purpose of the Study:

  • To determine if adding fentanyl to a bupivacaine loading dose enhances labor pain analgesia.
  • To evaluate the dose-dependent analgesic effects of fentanyl in combination with bupivacaine.

Main Methods:

  • Sixty parturients received epidural analgesia, randomly assigned to three groups.
  • Groups received either bupivacaine alone, or bupivacaine with 2 mcg/mL or 4 mcg/mL fentanyl as a loading dose.
  • Dermatome levels, side effects, and need for supplemental analgesia were assessed.

Main Results:

  • Higher fentanyl doses resulted in greater cephalic dermatome coverage (T7 with 4 mcg/mL fentanyl vs. T9 with 2 mcg/mL and T12 with none).
  • The need for supplemental analgesia decreased with increasing fentanyl dose (55% in no fentanyl, 30% with 2 mcg/mL, 0% with 4 mcg/mL).
  • Pruritus occurred in 35-40% of patients receiving fentanyl, but not in the bupivacaine-only group.

Conclusions:

  • Fentanyl addition to epidural bupivacaine provides dose-dependent analgesia for early labor pain.
  • A loading dose of 0.0625% bupivacaine with 4 mcg/mL fentanyl offers optimal segmental analgesia with minimal side effects.
  • This combination enhances analgesic effect and dermatome coverage during labor.