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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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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.
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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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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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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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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Regional Terms01:12

Regional Terms

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Regional terms describe anatomy by dividing the body parts into different regions that contain structures involved in contributing similar functions. Using these terms helps increase the accurate description and identification of the particular region of interest or region affected by the disease.
Primarily, the human body has two major regions, the axial and appendicular regions. The axial region comprises regions from the head to the abdomen and makes up the central body axis. In contrast,...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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

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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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Author Spotlight: Minimally Invasive Relief for Occipital Neuralgia at the Nuchal Line
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A checklist for performing regional nerve blocks.

Michael F Mulroy1, Robert S Weller, Gregory A Liguori

  • 1From the *Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA; †Department of Anesthesiology, Wake Forest School of Medicine, Winston, Salem, NC; and ‡Department of Anesthesiology, Hospital for Special Surgery, New York, NY.

Regional Anesthesia and Pain Medicine
|April 11, 2014
PubMed
Summary
This summary is machine-generated.

Regional blocks carry risks like infection and anesthetic toxicity. A new 9-point checklist, developed by the American Society of Regional Anesthesia and Pain Medicine (ASRA), aims to improve patient safety during these procedures.

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Area of Science:

  • Anesthesiology
  • Patient Safety
  • Medical Procedures

Background:

  • Regional blocks are invasive procedures with inherent risks, including infection, local anesthetic toxicity, and wrong-site blocks.
  • National guidelines exist to mitigate these risks, established by The Joint Commission and the American Society of Regional Anesthesia and Pain Medicine (ASRA).

Purpose of the Study:

  • To develop a formalized checklist incorporating recommended safety steps for regional blocks.
  • To reduce the potential for complications associated with regional anesthesia.

Main Methods:

  • A task force reviewed existing resources and recommendations.
  • A survey of members of the American Society of Regional Anesthesia and Pain Medicine (ASRA) was conducted at their annual meeting in May 2013.
  • A 9-point checklist was proposed based on the review and survey findings.

Main Results:

  • A 9-point checklist was proposed by an ASRA task force.
  • The checklist aims to standardize safety protocols for regional blocks.

Conclusions:

  • Formalizing safety steps into a checklist is a prudent approach to reduce errors and complications.
  • While local modifications may be necessary, the core principles of the proposed checklist should be adopted for regional block performance.