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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: 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 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...
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...

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Related Experiment Video

Updated: May 8, 2026

A Neonatal Rodent Model of Retroorbital Vein Injection
04:39

A Neonatal Rodent Model of Retroorbital Vein Injection

Published on: February 23, 2024

Regional anesthesia in neonates and infants.

Adrian Bosenberg1, Randall P Flick

  • 1Department of Anesthesiology and Pain Management, Faculty Health Sciences, Seattle Children's Hospital, University Washington, 4800 Sandpoint Way Northeast, Seattle, WA 98105, USA.

Clinics in Perinatology
|August 27, 2013
PubMed
Summary

Regional anesthesia provides effective pain management for neonates undergoing surgery. Ultrasound guidance enhances its feasibility, improving surgical outcomes and reducing NICU stays.

Keywords:
Brachial plexus blockadeCaudal blockEpidural anesthesiaFemoral nerve blockadeNeonatal careRegional anesthesiaSciatic nerve blockadeUltrasound

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Area of Science:

  • Neonatal surgery
  • Pain management
  • Regional anesthesia

Background:

  • Optimal pain management is crucial for surgical outcomes and length of stay in the neonatal intensive care unit (NICU).
  • Regional anesthesia offers an effective pain management alternative for both term and preterm neonates.
  • Neuraxial and peripheral nerve blocks are utilized for specific neonatal surgical and NICU procedures.

Purpose of the Study:

  • To highlight the role of regional anesthesia in neonatal pain management.
  • To discuss the application of neuraxial and peripheral nerve blocks in neonates.
  • To emphasize the importance of ultrasound guidance and staff training for implementing regional anesthesia in the NICU.

Main Methods:

  • Review of regional anesthesia techniques (neuraxial and peripheral nerve blocks) in neonates.
  • Discussion of the impact of ultrasound guidance on procedural feasibility.
  • Emphasis on the necessity of staff education for continuous epidural infusions.

Main Results:

  • Regional anesthesia is a viable and effective method for neonatal pain control.
  • Ultrasound guidance significantly improves the feasibility and safety of regional blocks in neonates.
  • Successful implementation requires adequate staff training and education on techniques like continuous epidural infusions.

Conclusions:

  • Regional anesthesia is a key strategy for optimizing surgical outcomes and NICU length of stay.
  • Ultrasound-guided regional blocks are increasingly feasible and beneficial for neonates.
  • Comprehensive training programs are essential for the widespread adoption of regional anesthesia in neonatal care.