Related Experiment Videos
Local anesthesia for lymphaticovenular anastomosis.
Vana S H Chan1, Mitsunaga Narushima, Hisako Hara
1From the Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Annals of Plastic Surgery
|April 2, 2013
Summary
Local anesthesia (LA) is a viable option for lymphaticovenular anastomosis, a procedure for lower limb lymphedema. Patients reported minimal intraoperative and postoperative pain, with no surgical complications.
Area of Science:
- Vascular Surgery
- Anesthesiology
- Lymphedema Management
Background:
- Lymphaticovenular anastomosis effectively treats lower limb lymphedema.
- Local anesthesia is infrequently used for this surgical procedure.
Purpose of the Study:
- To evaluate patient tolerance and pain levels during lymphaticovenular anastomosis performed under local anesthesia.
Main Methods:
- 14 patients underwent lymphaticovenular anastomosis under local anesthesia.
- Pain was assessed using a Visual Analogue Scale (VAS) for intraoperative and postoperative periods.
Main Results:
- Mean intraoperative pain score was consistently below 1 (0-10 scale).
- Mean postoperative pain was 1.6 on day one, decreasing thereafter.
- No surgical complications were reported among the participants.
Conclusions:
- Local anesthesia is a well-tolerated anesthetic option for lymphaticovenular anastomosis.
- Preoperative counseling and intraoperative measures enhance patient tolerance, making LA a feasible choice.
Related Concept Videos
01:16Local 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...
One of the advantages of...
01:11Local 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...
01:30Local 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...
01:23Local Anesthetics: Common Agents and Their Applications
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
01:13Local Anesthetics: Pharmacokinetics
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
01:30Local Anesthetics: Chemistry and Structure-Activity Relationship
Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...