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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: 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...
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 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...

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Related Experiment Video

Updated: May 21, 2026

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
08:05

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Published on: November 21, 2025

Peripheral nerve stimulation in regional anesthesia.

Stephen M Klein1, M Steve Melton, Warren M Grill

  • 1Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.

Regional Anesthesia and Pain Medicine
|June 12, 2012
PubMed
Summary
This summary is machine-generated.

Electrical nerve stimulation aids regional anesthesia by locating nerves, using current to gauge needle proximity. A motor response below 0.5 mA indicates successful nerve blockade, though factors like biology and equipment influence accuracy.

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Area of Science:

  • Anesthesiology
  • Neuroscience
  • Regional Anesthesia

Background:

  • Peripheral nerve stimulation is a long-standing technique in regional anesthesia.
  • Nerve stimulation is still popular, used alone or with ultrasound guidance.
  • Understanding its principles is crucial given its evolving role.

Purpose of the Study:

  • To review the basic concepts and knowledge of electrical nerve stimulation.
  • To highlight its utility in nerve localization for regional anesthesia.

Main Methods:

  • Electrical nerve stimulation uses threshold current as a surrogate for needle-to-nerve distance.
  • Motor nerves are preferentially activated due to shorter duration current requirements compared to sensory nerves.
  • A motor response at or below 0.5 mA is a common endpoint for successful neural blockade.

Main Results:

  • The current magnitude required to elicit a motor response correlates with needle-to-nerve distance.
  • Lower current thresholds indicate closer proximity to the target nerve.
  • Current magnitude is not perfectly sensitive or specific for successful blockade.

Conclusions:

  • Electrical nerve stimulation is a valuable tool for nerve localization in regional anesthesia.
  • Successful nerve stimulation depends on anatomical knowledge and electrophysiological understanding.
  • Environmental and equipment factors can influence the current-distance relationship.