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Local Anesthetics: Clinical Application as Spinal Anesthesia

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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...

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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.
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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 Anesthesia

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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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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.

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Updated: May 15, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

Recent developments in paediatric neuraxial blocks.

Vrushali Chandrashekhar Ponde¹

¹Department of Anaesthesia, Holy Family Hospital and Research Centre, Bandra, Mumbai, Maharashtra, India.

Indian Journal of Anaesthesia

|January 8, 2013

Summary

Recent advances in pediatric regional anesthesia enhance safety and efficacy. Techniques like ultrasound and electrical stimulation improve central neuraxial blocks, while peripheral blocks offer better risk-benefit profiles for specific surgeries.

Keywords:

Electrostimulation paediatric central neuraxial blocks recent developments ultrasound

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Published on: November 21, 2025

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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

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Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Published on: November 21, 2025

Area of Science:

Pediatric Anesthesiology
Regional Anesthesia Techniques
Pain Management in Children

Background:

Paediatric regional anaesthesia is integral to paediatric anaesthesia.
Regional blocks can supplement almost all paediatric surgeries.
Advances are crucial for improving safety and outcomes.

Purpose of the Study:

Review recent advancements in paediatric regional anaesthesia.
Elaborate on ultrasound and electrical stimulation for central neuraxial blocks.
Compare traditional and recent techniques, including peripheral blocks.

Main Methods:

Literature search of MEDLINE (PubMed) for the last 10 years.
Keywords: Recent advances in paediatric regional anaesthesia, ultrasound guidance, electrical stimulation, complications.
Review of full-text articles for relevance.

Main Results:

Ultrasound and electrical stimulation enhance safety and provide objective endpoints for central neuraxial blocks.
Peripheral blocks (e.g., penile, sciatic) offer improved risk-benefit ratios over central blocks for certain procedures.
Continuous epidural analgesia in paediatrics has evolved, retaining unique importance.

Conclusions:

Recent techniques in paediatric regional anaesthesia improve safety and efficacy.
Peripheral nerve blocks are increasingly considered for specific paediatric surgeries.
Careful consideration of block placement under sedation or general anaesthesia is vital.