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Related Concept Videos

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 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...
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: Common Agents and Their Applications01:23

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...
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...
Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...

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Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve
06:48

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Bier's block using lignocaine and butorphanol.

Abhishek Bansal1, Shikha Gupta, Dinesh Sood

  • 1Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, India.

Journal of Anaesthesiology, Clinical Pharmacology
|November 19, 2011
PubMed
Summary

Adding butorphanol to lignocaine in intravenous regional anesthesia (IVRA) significantly extends postoperative pain relief and reduces overall analgesic needs. However, it does not impact the onset or recovery of sensory block during IVRA procedures.

Keywords:
Bier's blockbutorphanolintravenous regional analgesiaintravenous regional anesthesialignocaine

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Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Opioids are commonly used adjuncts in intravenous regional anesthesia (IVRA) to enhance analgesia.
  • Limited research exists on butorphanol's use in IVRA.

Purpose of the Study:

  • To assess the benefits of adding butorphanol to lignocaine in Bier's block.
  • To evaluate effects on sensory block onset and duration, and postoperative analgesic requirements.

Main Methods:

  • A randomized, double-blind study involving 40 adult patients undergoing upper limb surgery.
  • Patients received either lignocaine alone or lignocaine with butorphanol.
  • Sensory block characteristics and postoperative pain were measured using pin prick and visual analogue scales.

Main Results:

  • Butorphanol significantly prolonged the duration of postoperative analgesia.
  • Patients receiving butorphanol required less analgesia in the first 24 hours.
  • No significant differences were observed in sensory block onset or recovery times.

Conclusions:

  • Butorphanol addition to lignocaine in IVRA improves postoperative analgesia duration and reduces consumption.
  • Butorphanol does not influence the onset or recovery of sensory block in IVRA.