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Related Concept Videos

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...
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General Anesthesia: Overview01:24

General Anesthesia: Overview

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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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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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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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Failed spinal anaesthesia for caesarean section.

Adenekan At1, Olateju So1

  • 1Department of Anaesthesia, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

Journal of the West African College of Surgeons
|December 3, 2014
PubMed
Summary

Spinal anesthesia failure during Cesarean sections occurred in 6.0% of cases, often due to anesthesiologist experience. Improved training can reduce Cesarean section anesthesia failures.

Keywords:
Caesarean sectionComplications of spinal anaesthesiaHeavy bupivacaineSpinal anaesthesia

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Area of Science:

  • Obstetrics and Gynecology
  • Anesthesiology
  • Regional Anesthesia

Background:

  • Spinal anesthesia is the preferred regional technique for Cesarean sections.
  • However, instances of spinal anesthesia failure requiring conversion or supplemental analgesia can occur.

Purpose of the Study:

  • To determine the incidence of spinal anesthesia failure in Cesarean sections.
  • To identify factors contributing to spinal anesthesia failure.
  • To assess the need for conversion to general anesthesia or supplemental analgesia.

Main Methods:

  • A prospective study involving 414 women undergoing Cesarean section with single-shot spinal anesthesia.
  • Data collected included demographic, clinical, surgical, and anesthetic details.
  • The study was conducted at a University Teaching Hospital in South-Western Nigeria.

Main Results:

  • The overall spinal anesthesia failure rate was 6.0%.
  • Anesthesiologist experience was a significant factor in failures requiring conversion to general anesthesia (p = 0.02).
  • Supplemental intra-operative analgesia was needed in 6.4% of cases, with postpartum sterilization, uterine exteriorization, and surgical complications identified as risk factors.

Conclusions:

  • The spinal anesthesia conversion rate in this study is higher compared to developed countries.
  • Enhanced training for anesthesia residents is recommended to decrease failure rates.
  • Patients undergoing sterilization during Cesarean section may require additional intra-operative analgesia.