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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

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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 Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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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: Pharmacokinetics01:13

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The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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General Anesthesia: Overview01:24

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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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Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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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...
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Regional anesthesia for vascular surgery.

James Flaherty1, Jean-Louis Horn1, Ryan Derby1

  • 1Stanford Hospital and Clinics, 300 Pasteur Drive, Room H3580, Stanford, CA 94305, USA.

Anesthesiology Clinics
|August 13, 2014
PubMed
Summary

Regional anesthesia is a safe and effective anesthetic choice for vascular surgery patients with comorbidities, offering an alternative to general anesthesia. This review covers its use in various vascular procedures, comparing techniques and outcomes.

Keywords:
Brachial plexus blockadeCervical plexus blockadeLumbar and lumbosacral plexus blockadePerioperative outcomesRegional anesthesiaTransversus abdominis plane blockVascular surgery

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Area of Science:

  • Anesthesiology
  • Vascular Surgery
  • Regional Anesthesia

Background:

  • Vascular surgery patients often have severe comorbidities, posing anesthetic challenges.
  • General anesthesia can cause significant cardiovascular and pulmonary complications in these patients.
  • Regional anesthesia offers a potential alternative to mitigate these risks.

Purpose of the Study:

  • To review the application of regional anesthesia in various vascular surgical procedures.
  • To compare regional anesthesia with other anesthetic techniques for vascular surgery.
  • To describe the techniques of regional anesthesia used in these contexts.

Main Methods:

  • Literature review focusing on anesthetic techniques for specific vascular surgeries.
  • Comparison of outcomes between regional and general anesthesia.
  • Description of regional anesthesia techniques.

Main Results:

  • Regional anesthesia is utilized for carotid endarterectomy, abdominal aortic aneurysm repair (open and endovascular), infrainguinal arterial bypass, lower extremity amputation, and arteriovenous fistula formation.
  • Evidence comparing anesthetic techniques is reviewed.
  • The article provides descriptions of the regional anesthesia techniques employed.

Conclusions:

  • Regional anesthesia is a viable anesthetic option for patients undergoing major vascular surgery.
  • It can help avoid the adverse cardiovascular and pulmonary effects associated with general anesthesia.
  • This review supports the use of regional anesthesia in selected vascular procedures.