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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...
General Anesthesia: Overview01:24

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...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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: 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...

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Related Experiment Video

Updated: May 24, 2026

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
08:50

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Published on: June 25, 2013

Does using a femoral nerve block for total knee replacement decrease postoperative delirium?

Sakura Kinjo1, Eunjung Lim, Laura P Sands

  • 1Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA 94143-0648, USA. kinjos@anesthesia.ucsf.edu.

BMC Anesthesiology
|March 13, 2012
PubMed
Summary
This summary is machine-generated.

Peripheral nerve blocks, specifically femoral nerve blocks, significantly reduced postoperative delirium in older patients undergoing knee replacement surgery. This suggests a potential non-opioid strategy for preventing delirium after surgery.

Related Experiment Videos

Last Updated: May 24, 2026

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
08:50

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Published on: June 25, 2013

Area of Science:

  • Anesthesiology
  • Geriatric Medicine
  • Neuroscience

Background:

  • Postoperative delirium (POD) is a common complication in older patients, associated with increased morbidity and mortality.
  • Peripheral nerve blocks (PNBs) may mitigate POD by reducing opioid requirements and their associated side effects.
  • The impact of PNBs on POD in elderly surgical patients remains understudied.

Purpose of the Study:

  • To investigate the effect of femoral nerve block (FNB) on the incidence of POD in older patients undergoing total knee replacement (TKR).
  • To compare postoperative pain levels and opioid consumption between patients receiving FNB and those receiving patient-controlled analgesia (PCA) only.

Main Methods:

  • Prospective cohort study of 85 patients undergoing TKR.
  • Cognitive function assessed preoperatively using the Telephone Interview for Cognitive Status (TICS).
  • Postoperative delirium evaluated using the Confusion Assessment Method (CAM); groups compared were FNB ± PCA and PCA only.

Main Results:

  • Overall incidence of POD was 48.1% on postoperative days 1 or 2.
  • The incidence of POD was significantly lower in the FNB group (25%) compared to the PCA-only group (61%) (P = 0.002).
  • No significant differences were observed in postoperative pain scores or total intravenous opioid use between the groups.

Conclusions:

  • Femoral nerve block is associated with a reduced incidence of postoperative delirium in older adults following TKR.
  • These findings support the potential of PNBs as a strategy to prevent POD.
  • A larger randomized controlled trial is warranted to confirm these preliminary results.