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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 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 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: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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.
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Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
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Optimal anaesthetic depth for LMA insertion.

Sudeep Krishnappa1, Pankaj Kundra

  • 1Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (J.I.P.M.E.R), Pondicherry, India.

Indian Journal of Anaesthesia
|December 17, 2011
PubMed
Summary
This summary is machine-generated.

Loss of motor response to jaw thrust is a reliable indicator for laryngeal mask airway (LMA) insertion, reducing apnea and propofol use. This method ensures better anesthetic depth control and hemodynamic stability.

Keywords:
Anaesthesiageneral drugslaryngeal mask airwaypropofol equipment

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Area of Science:

  • Anesthesiology
  • Airway Management
  • Pharmacology

Background:

  • Fixed-dose propofol for anesthesia induction can lead to inadequate or excessive depth.
  • This can result in airway complications and hemodynamic instability.
  • Reliable clinical indicators for anesthetic depth are needed for laryngeal mask airway (LMA) insertion.

Purpose of the Study:

  • To evaluate if loss of motor response to jaw thrust is a dependable clinical indicator of anesthetic depth for LMA insertion.
  • To compare the efficacy and safety of using jaw thrust response versus a fixed propofol dose for LMA insertion.

Main Methods:

  • 120 ASA I/II patients were randomized into two groups: fixed propofol dose (3 mg/kg) or dose to abolish jaw thrust response.
  • Anesthesia was induced, and LMA insertion was performed.
  • Mean arterial pressure (MAP), heart rate, and LMA insertion conditions were monitored.

Main Results:

  • Apnea occurred in 85% of patients receiving fixed propofol versus 2% in the jaw thrust group (P<0.0001).
  • Propofol consumption was higher in the fixed-dose group.
  • The fixed-dose group experienced significant MAP reduction post-induction, unlike the jaw thrust group.

Conclusions:

  • Loss of motor response to jaw thrust provides satisfactory conditions for LMA insertion.
  • This method offers a safer and more effective approach to anesthetic depth titration for LMA placement.