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Related Concept Videos

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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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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Related Experiment Video

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Temporary sacral neuromodulation under local anaesthesia using new anatomical reference points.

S Prapasrivorakul1, K J Gorissen, M P Gosselink

  • 1Department of Colorectal Surgery, Oxford Pelvic Floor Centre, Churchill Hospital, Oxford University Hospitals, Oxford, OX3 7LJ, UK.

Techniques in Coloproctology
|August 25, 2014
PubMed
Summary
This summary is machine-generated.

Temporary sacral neuromodulation, a screening phase for sacral nerve stimulators, can be reliably performed in an outpatient setting under local anesthesia. This method is practical, cost-effective, and well-tolerated by patients.

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Area of Science:

  • Neurology
  • Urology
  • Pain Management

Background:

  • Sacral nerve stimulation requires a screening phase before implanting expensive devices.
  • This study evaluates the feasibility of temporary sacral neuromodulation under local anesthesia in an outpatient setting.

Purpose of the Study:

  • To assess the technique, outcomes, and patient satisfaction of temporary sacral neuromodulation in an outpatient setting.
  • To determine the feasibility of performing percutaneous nerve evaluation without fluoroscopy.

Main Methods:

  • 184 patients underwent percutaneous nerve evaluation using new reference points and local anesthesia.
  • A test wire was inserted without fluoroscopy, guided by bony landmarks (coccyx tip, sacro-coccygeal joint, posterior superior iliac spine).
  • Technical success was defined as perineal/anal stimulation at <6 mAmp; 24 patients reported pain and satisfaction.

Main Results:

  • Technical success was achieved in 93% (171/184) of patients.
  • 12 patients required fluoroscopy due to lack of sensation, pain, or difficulty identifying nerve roots.
  • 92% of patients would recommend the outpatient procedure under local anesthesia.

Conclusions:

  • Temporary sacral neuromodulation is a reliable, practical, and cost-effective outpatient procedure.
  • Local anesthesia does not adversely affect the test outcome for sacral neuromodulation.
  • This approach offers a feasible alternative for the screening phase of sacral nerve stimulation.