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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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 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...

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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: 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...

Depolarizing Blockers: Pharmocokinetics

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...

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...

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Related Experiment Video

Updated: Jun 17, 2026

Efficacy of Fu's Subcutaneous Needling on Sciatic Nerve Pain: Behavioral and Electrophysiological Changes in a Chronic Constriction Injury Rat Model

Efficacy of Fu's Subcutaneous Needling on Sciatic Nerve Pain: Behavioral and Electrophysiological Changes in a Chronic Constriction Injury Rat Model

Published on: June 30, 2023

[Sciatic nerve block in prehospital care].

T Gros¹, P Amaru, C Basuko

¹Service d'anesthésie, clinique Beau-Soleil, 119 avenue de Lodève, Montpellier, France. t.gros@languedoc-mutualite.fr

Annales Francaises D'Anesthesie Et De Reanimation

|January 15, 2010

Summary

This summary is machine-generated.

Prehospital sciatic nerve blocks effectively reduce pain from severe leg and foot trauma. This study suggests considering this technique for emergency medical services to improve patient outcomes.

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Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

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Efficacy of Fu's Subcutaneous Needling on Sciatic Nerve Pain: Behavioral and Electrophysiological Changes in a Chronic Constriction Injury Rat Model

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Partial Sciatic Nerve Ligation: A Mouse Model of Chronic Neuropathic Pain to Study the Antinociceptive Effect of Novel Therapies

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Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Published on: November 21, 2025

Area of Science:

Emergency medicine
Pain management
Regional anesthesia

Context:

Severe leg and foot trauma often requires immediate pain relief.
Prehospital care settings present unique challenges for pain management.
The sciatic nerve block is a potential analgesic option for these injuries.

Purpose:

To evaluate the analgesic efficacy of the sciatic nerve block in prehospital care for severe leg or foot trauma.
To compare different approaches (e.g., upper vs. lateral popliteal) and the use of neurostimulators.

Summary:

A retrospective study analyzed 23 prehospital sciatic nerve blocks for severe leg/foot trauma.
Significant pain reduction was observed across various methods and time points.
Faster analgesia onset was noted with the upper approach and neurostimulator use; complications were minimal.

Impact:

Prehospital sciatic nerve blocks demonstrate significant analgesic effectiveness.
Findings support further evaluation for integrating this technique into emergency medical services.
This approach could enhance pain management for trauma patients prior to hospital arrival.