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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

2.0K
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...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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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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General Anesthesia: Overview01:24

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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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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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.
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Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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...
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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy

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Spinal anesthesia in children: A review.

Anju Gupta1, Usha Saha2

  • 1Department of Anesthesiology and Intensive Care, Delhi State Cancer Hospital, Dilshad Garden, New Delhi, India.

Journal of Anaesthesiology, Clinical Pharmacology
|February 28, 2014
PubMed
Summary

Spinal anesthesia (SA) offers a safe and effective alternative to general anesthesia (GA) in children, with minimal cardio-respiratory impact. Further research supports its expanded use beyond neonates for various pediatric procedures.

Keywords:
Additiveschildrencomplicationspediatricregional anesthesiaspinalspinal anesthesia

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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia
  • Neuroanesthesia

Background:

  • Spinal anesthesia (SA) is underutilized in pediatrics despite a strong safety record, often reserved for high-risk neonates.
  • General anesthesia (GA) raises concerns regarding neurotoxicity in developing brains, prompting reevaluation of anesthetic alternatives.
  • SA offers advantages like minimal cardio-respiratory disturbance, making it appealing for pediatric patients.

Purpose of the Study:

  • To review the safety and efficacy of spinal anesthesia (SA) in pediatric patients.
  • To explore the potential of SA as a primary anesthetic technique for a wider range of pediatric procedures.
  • To discuss the benefits of SA in light of concerns about GA's effects on the developing brain.

Main Methods:

  • Comprehensive literature review of studies on pediatric spinal anesthesia.
  • Analysis of safety data and efficacy for various pediatric surgical procedures.
  • Evaluation of adjuvants used to prolong SA duration and their safety profiles.

Main Results:

  • SA demonstrates a favorable safety profile with low incidence of side effects and no reported permanent neurological sequelae.
  • Adjuvants can effectively extend SA duration, addressing a key limitation for pediatric surgeries.
  • SA provides balanced anesthesia with minimal cardio-respiratory compromise, beneficial for pediatric patients.

Conclusions:

  • Spinal anesthesia is a safe and effective option for pediatric anesthesia, suitable for a broader patient population than currently practiced.
  • Concerns regarding GA's impact on developing brains may increase the utility of SA in pediatric care.
  • Experienced providers and careful drug selection are crucial for successful pediatric SA implementation.