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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...
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...
Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action01:17

Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action

Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
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...

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Related Experiment Video

Updated: May 29, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Neuraxial blockade for external cephalic version: a systematic review.

P Sultan1, B Carvalho

  • 1Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA 94305, USA. p.sultan@doctors.org.uk

International Journal of Obstetric Anesthesia
|September 20, 2011
PubMed
Summary
This summary is machine-generated.

Neuraxial blockade, a method to relax muscles and ease discomfort, significantly improves external cephalic version success rates. This technique appears safe for both mother and baby, aiding in vaginal birth.

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Related Experiment Videos

Last Updated: May 29, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
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Published on: January 31, 2025

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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Published on: June 25, 2013

Area of Science:

  • Obstetrics and Gynecology
  • Anesthesiology
  • Maternal-Fetal Medicine

Background:

  • External cephalic version (ECV) is increasingly considered to reduce cesarean delivery rates.
  • Neuraxial blockade aims to facilitate ECV by promoting fetal repositioning through muscle relaxation and reduced patient discomfort.

Purpose of the Study:

  • To systematically review the evidence on the safety and efficacy of neuraxial anesthesia or analgesia for facilitating ECV.

Main Methods:

  • A systematic literature review was conducted.
  • Searched Medline, Cochrane, EMBASE, and Web of Sciences databases for English articles published between 1945 and 2010.
  • Included six randomized controlled studies and six non-randomized studies.

Main Results:

  • Neuraxial blockade significantly increased ECV success rates in four of six randomized controlled studies.
  • Four of six non-randomized studies also found increased ECV success with neuraxial blockade.
  • Adverse events like placental abruption and non-reassuring fetal heart rate were rare and comparable to control groups.

Conclusions:

  • Neuraxial blockade enhances the likelihood of successful external cephalic version.
  • Optimal dosing regimens require further clarification; anesthetic doses may be more effective than analgesic doses.
  • Neuraxial blockade does not appear to compromise maternal or fetal safety during ECV.