Related Experiment Video
Updated: Apr 28, 2026
03:14
Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
2.2K
Neuraxial anesthesia for outpatients
Elizabeth A Alley1, Michael F Mulory1
1Department of Anesthesia, Virginia Mason Medical Center, B2-AN, 1100 Ninth Avenue, Post Box 900, Seattle, WA 98101, USA.
Anesthesiology Clinics
|June 3, 2014
Summary
Neuraxial anesthesia, particularly with short-acting agents like 2-chloroprocaine, offers safe and effective pain management for outpatient surgeries. This approach is ideal for procedures lasting 90 minutes or longer, minimizing risks.
Area of Science:
- Anesthesiology
- Surgical Procedures
Background:
- Neuraxial anesthesia is a viable option for outpatient surgery.
- Short-acting local anesthetics are crucial for outpatient procedures.
- Transient neurologic symptoms (TNS) are a concern with some anesthetics.
Purpose of the Study:
- To evaluate the suitability of neuraxial anesthesia for outpatient surgery.
- To assess the efficacy and safety of 2-chloroprocaine for short outpatient procedures.
- To determine the utility of epidural anesthesia with short-acting agents for longer outpatient procedures.
Main Methods:
- Utilized short-acting local anesthetic 2-chloroprocaine.
- Administered epidural anesthesia for outpatient procedures.
- Focused on procedures with a duration of 90 minutes or longer.
Main Results:
- 2-chloroprocaine demonstrated an appropriate duration of action for short outpatient procedures.
- The risk of transient neurologic symptoms was very low with 2-chloroprocaine.
- Epidural anesthesia with short-acting agents provided good anesthesia for procedures exceeding 90 minutes.
Conclusions:
- Neuraxial anesthesia is effective for select outpatient surgeries.
- 2-chloroprocaine is a safe and effective option for short outpatient procedures due to its action profile and low TNS risk.
- Epidural anesthesia using short-acting agents is suitable for outpatient procedures lasting 90 minutes or more.
Related Concept Videos
01:11Local 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...
2.0K
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
1.0K
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...
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
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
2.2K
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...
One of the advantages of...
2.2K
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
2.8K
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...
2.8K
01:24General Anesthesia: Overview
1.1K
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...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
1.1K
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
1.7K
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...
1.7K