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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 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 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: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...

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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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Published on: June 25, 2013

Bilateral transversus abdominis plane block does not decrease postoperative pain after laparoscopic cholecystectomy

Jaime Ortiz1, James W Suliburk, Kenneth Wu

  • 1Department of Anesthesiology, Baylor College of Medicine, Houston, TX 77030, USA. jaimeo@bcm.edu

Regional Anesthesia and Pain Medicine
|February 15, 2012
PubMed
Summary

Bilateral transversus abdominis plane (TAP) blocks provide pain relief after laparoscopic cholecystectomy, similar to local anesthetic infiltration. This study found no significant difference in postoperative pain or analgesic use between the two methods.

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Area of Science:

  • Anesthesiology
  • Surgical Pain Management

Background:

  • Transversus abdominis plane (TAP) block is recognized for reducing pain and analgesic needs post-abdominal surgery.
  • Laparoscopic cholecystectomy is a common abdominal procedure where effective pain management is crucial.

Purpose of the Study:

  • To compare the efficacy of bilateral TAP blocks versus local anesthetic infiltration of trocar sites for postoperative pain control.
  • To evaluate analgesic requirements in patients undergoing laparoscopic cholecystectomy.

Main Methods:

  • Eighty patients were randomized into two groups: bilateral TAP block or local anesthetic infiltration.
  • Postoperative pain scores and 24-hour analgesic consumption were recorded.
  • Data were analyzed for 39 patients in the TAP block group and 35 in the infiltration group.

Main Results:

  • No statistically significant difference in pain scores was observed between the bilateral TAP block and local anesthetic infiltration groups at 4 hours or over 24 hours post-surgery.
  • There was no significant difference in the total analgesic use within the first 24 hours between the groups.
  • The time from anesthesia start to surgery start was significantly longer in the TAP block group.

Conclusions:

  • Bilateral ultrasound-guided TAP block is equivalent to local anesthetic infiltration for managing overall postoperative pain in laparoscopic cholecystectomy patients.
  • Both techniques demonstrated similar efficacy in pain control and analgesic use for this patient population.