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Related Concept Videos

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.
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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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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Related Experiment Video

Updated: Apr 10, 2026

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
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Anaesthetic and pharmacological techniques to decrease blood loss in liver surgery: a systematic review.

Samir Pathak1, Abdul Hakeem1, Thomas Pike1

  • 1Department of HPB and Transplant Surgery, St James's University Hospital NHS Trust, Leeds, West Yorkshire, UK.

ANZ Journal of Surgery
|June 16, 2015
PubMed
Summary
This summary is machine-generated.

Non-surgical methods may reduce bleeding during liver surgery (hepatectomy). However, current evidence is too varied to recommend a specific strategy for decreasing perioperative blood loss.

Keywords:
blood lossblood transfusionliver surgery

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Anesthesiology

Background:

  • Perioperative blood loss and transfusions negatively impact outcomes after hepatectomy.
  • Identifying methods to reduce intraoperative bleeding is crucial for improving patient results.

Purpose of the Study:

  • To systematically review non-surgical strategies for minimizing intraoperative blood loss during liver surgery.

Main Methods:

  • Comprehensive literature search across major databases (PubMed, Embase, Cochrane, CINAHL, Google Scholar).
  • Included randomized controlled studies evaluating pharmacological and anesthetic methods.
  • Primary outcomes: perioperative blood loss and transfusion needs; Secondary outcome: ischemia-reperfusion injury.

Main Results:

  • Seventeen randomized controlled trials involving 1573 patients were analyzed.
  • Eight studies (n=894) examined pharmacological methods; nine studies (n=679) examined anesthetic methods.
  • Investigated interventions included anti-fibrinolytic drugs, acute normovolemic hemodilution, autologous blood donation, and inhalational anesthetics.

Conclusions:

  • Non-surgical techniques show potential for reducing perioperative bleeding in liver surgery.
  • Heterogeneity among trials prevents recommending a specific strategy at this time.
  • Further high-quality research is needed to establish optimal bleeding reduction pathways.