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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

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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 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...

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Reducing post-lumbar puncture headaches with small bore atraumatic needles.

Eric D Vidoni¹, Jill K Morris¹, Kayla Raider²

¹University of Kansas Alzheimer's Disease Center, 4350 Shawnee Mission Parkway, MS 6002 Fairway, KS 66205, USA.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia

|October 26, 2013

Summary

Using a 24-gauge atraumatic needle significantly reduces post-lumbar puncture headache (PLPH) in Alzheimer's disease patients. This finding supports using these specific needles for diagnostic lumbar punctures in aging populations.

Keywords:

Alzheimer’s Biomarkers Dementia

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Area of Science:

Neurology
Medical Diagnostics

Background:

Lumbar puncture is increasingly used for Alzheimer's disease diagnosis.
Minimizing adverse effects like post-lumbar puncture headache (PLPH) is crucial for patient care.
Previous research suggests small, atraumatic needles reduce PLPH.

Purpose of the Study:

To evaluate the effectiveness of atraumatic needles in reducing PLPH within an aging Alzheimer's disease cohort.
To provide evidence-based recommendations for lumbar puncture procedures in this demographic.

Main Methods:

Analysis of PLPH occurrence in the Alzheimer's Disease Neuroimaging Initiative cohort.
Comparison of PLPH rates based on needle size and type, specifically focusing on 24-gauge atraumatic needles.

Main Results:

PLPH occurrence was significantly reduced only when employing a 24-gauge atraumatic needle.
The study confirmed the benefit of this needle type in the studied aging population.

Conclusions:

Recommend the use of 24-gauge atraumatic needles for all lumbar punctures in Alzheimer's disease patients.
Implementing this recommendation can improve patient comfort and adherence to diagnostic testing.