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Related Concept Videos

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: 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...
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.
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...
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 12, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Analgesia/anesthesia for external cephalic version.

Carolyn F Weiniger1

  • 1Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel. carolynfweiniger@gmail.com

Current Opinion in Anaesthesiology
|April 26, 2013
PubMed
Summary
This summary is machine-generated.

External cephalic version (ECV) is a low-risk procedure to convert breech presentations to cephalic. Neuraxial anesthesia significantly improves ECV success rates, increasing vaginal delivery likelihood.

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Last Updated: May 12, 2026

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Published on: October 25, 2015

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Surgical Innovation

Background:

  • Professional guidelines recommend cesarean delivery for breech presentation due to fetal risks.
  • External cephalic version (ECV) is an alternative to enable vaginal delivery.
  • Physician and patient factors contribute to the infrequent offering of ECV.

Purpose of the Study:

  • To review attitudes towards ECV.
  • To examine pain relief methods and their impact on ECV success.
  • To assess the efficacy of neuraxial techniques in ECV.

Main Methods:

  • Review of existing literature on ECV and pain management.
  • Analysis of factors influencing ECV success rates.
  • Evaluation of neuraxial techniques (spinal/epidural) in ECV.

Main Results:

  • ECV success is higher in multiparous women, complete breech, posterior placenta, or smaller fetuses.
  • Neuraxial techniques (high-dose local anesthetic) significantly increase ECV success rates and vaginal delivery rates.
  • Preterm ECV does not increase overall vaginal delivery rates; ECV is a low-risk procedure.

Conclusions:

  • Routine ECV logistics and optimal neuraxial techniques require further research.
  • The safety of neuraxial anesthesia for ECV necessitates additional investigation.
  • While ECV doesn't increase cephalic presentation rates, it enhances vaginal delivery rates.