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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 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...
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...
Depolarizing Blockers: Pharmocokinetics01:19

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...
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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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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Published on: June 25, 2013

Subdural block and the anaesthetist.

D Agarwal1, M Mohta, A Tyagi

  • 1Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. deeptisachin@yahoo.co.in

Anaesthesia and Intensive Care
|March 3, 2010
PubMed
Summary
This summary is machine-generated.

Accidental subdural block during neuraxial anesthesia is a poorly understood complication. Awareness and early detection are key to preventing serious issues from this anesthesia complication.

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Area of Science:

  • Anesthesiology
  • Neurosurgery
  • NeuraI Anesthesia

Background:

  • Accidental subdural block is a recognized but poorly understood complication of neuraxial anesthesia.
  • Clinical presentations are often misattributed to other causes, delaying diagnosis and management.
  • Understanding the anatomy of the subdural space is crucial for comprehending this complication.

Purpose of the Study:

  • To increase awareness among anesthesiologists regarding inadvertent subdural block.
  • To review the anatomy, incidence, predisposing factors, presentation, diagnosis, and management of subdural block.

Main Methods:

  • Literature review of case reports and existing studies on subdural block.
  • Analysis of anatomical factors contributing to subdural drug deposition.
  • Synthesis of information on clinical presentation, diagnosis, and management strategies.

Main Results:

  • Subdural injection can cause high sensory block, potentially involving cranial nerves, disproportionate to the dose.
  • Presentation can be variable, including failure of the intended block or unexpected spread.
  • Predisposing factors and anatomical considerations influence the occurrence and presentation of subdural block.

Conclusions:

  • High index of suspicion is necessary for early detection of subdural block.
  • Prompt diagnosis and appropriate management can prevent further complications.
  • Increased awareness and understanding of neuraxial anatomy are vital for anesthesiologists.