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Local Anesthetics: Clinical Application as Epidural Anesthesia

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 Spinal Anesthesia

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 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...

General Anesthesia: Overview

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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...

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Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head

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AREA: an augmented reality system for epidural anaesthesia.

Hussam Al-Deen Ashab¹, Victoria A Lessoway, Siavash Khallaghi

¹Electrical and Computer Engineering Department, University of British Columbia, Vancouver, BC, Canada.

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

|February 1, 2013

Summary

This study introduces an augmented reality system for precise lumbar vertebral level identification during spinal procedures. The system significantly improves accuracy over manual palpation, enhancing procedural safety and effectiveness.

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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

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Published on: January 31, 2025

Area of Science:

Medical Imaging
Augmented Reality
Anesthesiology

Background:

Spinal needle injection procedures, including lumbar epidurals, are crucial for anesthesia and analgesia.
Accurate identification of vertebral levels is essential for effective therapy delivery and avoiding spinal cord injury.
Current manual palpation methods for vertebral level identification have a low success rate (around 30%).

Purpose of the Study:

To develop and evaluate an augmented reality (AR) system for accurate lumbar vertebral level identification.
To improve upon the accuracy of traditional manual palpation techniques in spinal procedures.

Main Methods:

Development of an AR system integrating a real-time tracked ultrasound transducer and a trinocular camera system.
Implementation of automatic ultrasound panorama generation for an extended lumbar vertebrae view.
Utilized image processing for automatic vertebral level identification and overlaid results on a live patient view.

Main Results:

The AR system achieved an average success rate of 85% for vertebral segmentation across 10 subjects.
The automatic level identification demonstrated an average accuracy of 6.6 mm.
Validation was performed on diverse ultrasound data, considering variations in spinal curvature.

Conclusions:

The developed prototype AR system significantly enhances the accuracy of vertebral level identification compared to manual methods.
This technology holds potential for improving the safety and efficacy of spinal needle injection procedures.