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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: 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 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 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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Related Experiment Video

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

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Nerve localization techniques for peripheral nerve block and possible future directions.

L Helen1, B D O'Donnell2, E Moore1

  • 1Sensing and Separation Group, Chemistry Department and Life Science Interface Group, Tyndall National Institute, University College Cork, Cork, Ireland.

Acta Anaesthesiologica Scandinavica
|May 23, 2015
PubMed
Summary
This summary is machine-generated.

Ultrasound-guided peripheral nerve blocks (PNB) are standard, but precisely locating the needle tip relative to the nerve is challenging. New technologies may soon improve the accuracy and safety of PNB procedures.

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Area of Science:

  • Regional Anesthesia
  • Medical Imaging
  • Ultrasound Technology

Background:

  • Ultrasound guidance is standard for peripheral nerve blocks (PNB), enabling visualization of nerves, needles, and anesthetics.
  • Accurate local anesthetic deposition near the nerve is crucial for successful PNB.
  • Current limitations in visualizing needle tip and nerve surface obscure the precise needle-nerve relationship during injection, risking nerve injury.

Purpose of the Study:

  • To review the evolution of nerve localization in regional anesthesia.
  • To identify challenges in ultrasound-guided nerve blocks.
  • To explore technological solutions for improving needle-nerve relationship visualization.

Main Methods:

  • Literature review on nerve localization techniques in regional anesthesia.
  • Analysis of current challenges in ultrasound-guided peripheral nerve blocks.
  • Exploration of emerging technologies for enhanced needle-nerve visualization.

Main Results:

  • Current technologies for PNB include real-time 3D imaging, magnetic needle guidance, and injection pressure monitoring.
  • Optical reflectance spectroscopy and bioimpedance are proposed as potential solutions for accurately identifying the needle-nerve relationship.
  • Accurate needle-nerve relationship identification remains a critical unmet need in PNB.

Conclusions:

  • Defining the precise needle-nerve relationship at injection is essential for safe peripheral nerve blocks.
  • Further research into new technologies is needed to address current visualization limitations.
  • Clinical best practices should be followed until definitive technological solutions are available.