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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 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...

General Anesthesia: Overview

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

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Related Experiment Video

Updated: May 29, 2026

The Modified Single-working Portal Technique Using Lasso-loop Stitch with Needle for Arthroscopic Subscapularis Repair

The Modified Single-working Portal Technique Using Lasso-loop Stitch with Needle for Arthroscopic Subscapularis Repair

Published on: August 8, 2025

[Shoulder surgery using only regional anaesthesia].

Claire Tilbury¹, Paulien M van Kampen, Tom A M M Offenberg

¹HagaZiekenhuis, locatie Sportlaan, Afd. Orthopedie, Den Haag, the Netherlands. clairetilbury@live.nl

Nederlands Tijdschrift Voor Geneeskunde

|September 24, 2011

Summary

A new interscalene regional anaesthetic block technique for arthroscopic shoulder surgery improves patient outcomes. This method offers better pain relief and satisfaction compared to general anaesthesia.

Related Experiment Videos

Last Updated: May 29, 2026

The Modified Single-working Portal Technique Using Lasso-loop Stitch with Needle for Arthroscopic Subscapularis Repair

The Modified Single-working Portal Technique Using Lasso-loop Stitch with Needle for Arthroscopic Subscapularis Repair

Published on: August 8, 2025

Area of Science:

Anesthesiology
Orthopaedic Surgery
Regional Anesthesia

Context:

Interscalene block is a regional anesthesia technique.
Arthroscopic shoulder surgery requires effective anesthesia and pain management.
The lateral decubitus position is a patient positioning technique.

Purpose:

To evaluate the effectiveness of interscalene block combined with lateral decubitus position for arthroscopic shoulder surgery.
To compare this technique with general anesthesia regarding peri-operative conditions, analgesia, patient satisfaction, and complications.

Summary:

A novel approach using interscalene block without general anesthesia in the lateral decubitus position was introduced for arthroscopic shoulder surgery in the Netherlands.
This technique demonstrated improved peri-operative conditions for patients.
Reported benefits include superior analgesia, enhanced patient satisfaction, and a reduced complication rate compared to general anesthesia.

Impact:

This technique offers a potentially safer and more effective alternative for arthroscopic shoulder surgery.
Improved patient satisfaction and reduced complications can lead to better overall surgical recovery.
Highlights the benefits of regional anesthesia in enhancing patient care during orthopaedic procedures.