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Related Concept Videos

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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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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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...
1.0K
Drug Delivery: Parenteral Route01:29

Drug Delivery: Parenteral Route

2.8K
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
2.8K
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

1.8K
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
1.8K
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

1.3K
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...
1.3K

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Related Experiment Video

Updated: May 2, 2026

Author Spotlight: Unveiling the Therapeutic Effects of FSN Treatment – Bridging Research and Clinical Applications in Neuropathic Pain
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Multivesicular liposomal bupivacaine at the sciatic nerve.

J Brian McAlvin1, Robert F Padera2, Sahadev A Shankarappa3

  • 1Department of Medicine, Division of Medicine Critical Care, Harvard Medical School, Boston Children's Hospital, Boston, MA 02115, USA; Laboratory for Biomaterials and Drug Delivery, Department of Anesthesiology, Division of Critical Care Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 77 Massachusetts Ave, Building 76-661, Cambridge, MA 02139, USA.

Biomaterials
|March 12, 2014
PubMed
Summary

Exparel, a liposomal bupivacaine formulation, showed comparable tissue reactions to standard bupivacaine HCl in rats. Further clinical evaluation is needed to monitor local tissue injury.

Keywords:
BupivacaineDepoFoamExparel™InflammationMyotoxicityNeurotoxicity

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An In Vivo Murine Sciatic Nerve Model of Perineural Invasion
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An In Vivo Murine Sciatic Nerve Model of Perineural Invasion
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Area of Science:

  • Pharmacology
  • Toxicology
  • Biocompatibility

Background:

  • Clinical use of sustained-release local anesthetics is hindered by tissue reactions.
  • Exparel (DepoFoam bupivacaine) is a novel liposomal formulation with uncharacterized nerve tissue biocompatibility.

Purpose of the Study:

  • To evaluate the biocompatibility and tissue reaction of Exparel compared to bupivacaine HCl formulations in a rat sciatic nerve model.

Main Methods:

  • Rats received sciatic nerve injections of Exparel, 0.5% bupivacaine HCl, or 1.31% bupivacaine HCl.
  • Nerve blockade duration, inflammation, myotoxicity, and neurotoxicity were assessed at 4 days and 2 weeks post-injection.

Main Results:

  • Exparel provided longer sciatic nerve blockade (240 min) than bupivacaine HCl formulations.
  • At 4 days, Exparel showed slightly higher median inflammation scores but similar myotoxicity compared to 0.5% bupivacaine HCl.
  • At 2 weeks, inflammation from Exparel was greater than 0.5% bupivacaine HCl but similar to 1.31% bupivacaine HCl; myotoxicity was not significantly different across groups.
  • No neurotoxicity was detected in any group.

Conclusions:

  • Exparel's tissue reaction in rats was comparable to 0.5% bupivacaine HCl.
  • While Exparel demonstrated prolonged anesthetic effect, careful surveillance for local tissue injury is crucial in future clinical trials.