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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 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.
One of the advantages of...
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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 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 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.
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Updated: Apr 17, 2026

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
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Published on: November 21, 2025

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High-frequency electrical nerve block for postamputation pain: a pilot study.

Amol Soin1, Nemath Syed Shah, Zi-Ping Fang

  • 1Ohio Pain Clinic, Dayton, OH, USA.

Neuromodulation : Journal of the International Neuromodulation Society
|February 7, 2015
PubMed
Summary
This summary is machine-generated.

Kilohertz alternating current nerve blocks offer significant pain relief for amputees with intractable limb pain. This pilot study shows sustained efficacy and safety, supporting further investigation for regulatory approval.

Keywords:
Neuromodulationperipheral nervephantom painresidual limb painsciatic nervestump paintibial nerve

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Area of Science:

  • Neurology
  • Pain Management
  • Biomedical Engineering

Background:

  • Intractable limb pain, including residual limb pain and phantom limb pain, significantly impacts amputees' quality of life.
  • Current treatments for chronic postamputation pain have limitations, necessitating novel therapeutic approaches.

Purpose of the Study:

  • To evaluate the analgesic efficacy and safety of kilohertz alternating current (kHz-AC) applied to peripheral nerves in amputees experiencing intractable limb pain.
  • To assess the potential of kHz-AC nerve block as a treatment for postamputation pain.

Main Methods:

  • A pilot study involving ten lower-limb amputees with severe chronic limb pain was conducted.
  • Cuff electrodes were placed around the sciatic or tibial nerve, delivering 10 kHz sinusoidal waveforms.
  • Pain intensity was recorded using a diary, with responders later receiving an implantable generator.

Main Results:

  • Seven out of ten subjects achieved significant pain reduction (average 75%) at three months, meeting responder criteria.
  • Treatment led to reduced pain medication use and improved functional capacity.
  • Efficacy was sustained for up to 12 months, with good device tolerability and no observed impact on motor or sensory function.

Conclusions:

  • Kilohertz electrical nerve block demonstrates preliminary efficacy and safety for managing postamputation pain.
  • These findings support the progression to a pivotal study for potential regulatory approval.