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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...

Local Anesthetics: Common Agents and Their Applications

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...

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...

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...

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Related Experiment Video

Updated: Jun 3, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

[Ropivacaina 0.5% vs Levobupivacaina 0.5 endoscopic urological surgery].

Alessandro Fasciolo¹, Claudio Baldini

¹U.O.C. Anestesia e Terapia Iperbarica, Azienda Ospedaliera Universitaria Ospedale San Martino, Genova, Italy. ale.fasciolo@hotmail.it

|April 1, 2011

Summary

This study compared isobaric ropivacaine and levobupivacaine for subarachnoid anesthesia in elderly patients undergoing urological surgery. Both anesthetics showed similar efficacy and safety, with a notable benefit of faster motor function recovery with ropivacaine.

Related Experiment Videos

Last Updated: Jun 3, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

Area of Science:

Anesthesiology
Geriatric Medicine
Urology

Background:

Subarachnoid anesthesia is safe and effective in elderly patients.
Isobaric ropivacaine 0.5% is a new option for subarachnoid anesthesia.

Purpose of the Study:

To compare isobaric ropivacaine 0.5% with 0.5% levobupivacaine in elderly patients undergoing endoscopic urological surgery.
To evaluate safety, efficacy, and recovery profiles of these agents.

Main Methods:

A randomized trial involving 50 elderly patients undergoing urological surgery.
Group L (n=25) received 15 mg levobupivacaine; Group R (n=25) received 18.05 mg ropivacaine.
Statistical analysis included Bonferroni test and variance analysis.

Main Results:

No significant differences in onset and duration of sensory/motor block between groups.
Similar perioperative complications, analgesic needs, and patient satisfaction.
A high prevalence of comorbidities was observed in the study population.

Conclusions:

Optimal dosing for ropivacaine and levobupivacaine in elderly patients requires further investigation.
Standardized dosing may need re-evaluation for this population.
Faster postoperative motor recovery with ropivacaine is a significant advantage, potentially reducing cognitive alterations.