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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: 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: Adverse Effects01:12

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
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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

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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.
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Does Neuraxial Anesthesia Decrease Transfusion Rates Following Total Hip Arthroplasty?

Bryan D Haughom1, William W Schairer2, Benedict U Nwachukwu2

  • 1Department of Orthopaedic Surgery, Rush University, Chicago, Illinois.

The Journal of Arthroplasty
|June 17, 2015
PubMed
Summary

Neuraxial anesthesia reduces perioperative transfusions and complications for total hip arthroplasty (THA). This approach also shortens operative time and hospital stay, offering a safer alternative to general anesthesia.

Keywords:
NSQIPepiduralneuraxial anesthesiaspinaltotal hip arthroplastytransfusion

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Area of Science:

  • Anesthesiology
  • Orthopedic Surgery
  • Health Services Research

Background:

  • Perioperative transfusions are linked to increased complications and costs in total hip arthroplasty (THA).
  • Existing studies on neuraxial anesthesia and blood loss in THA are limited by small sample sizes and population heterogeneity.

Purpose of the Study:

  • To compare transfusion rates in THA patients undergoing neuraxial versus general anesthesia.
  • To identify risk factors associated with perioperative transfusions in THA.

Main Methods:

  • Utilized the National Surgical Quality Improvement Program (NSQIP) database.
  • Analyzed data from 28,857 THAs performed between 2005 and 2012, including 11,317 with neuraxial anesthesia.
  • Employed univariate and multivariate regression analyses to compare outcomes and identify risk factors.

Main Results:

  • Neuraxial anesthesia was associated with significantly lower rates of transfusion, pneumonia, unplanned and prolonged intubation, stroke, and overall medical complications.
  • Patients receiving neuraxial anesthesia experienced shorter operative times and hospital lengths of stay.
  • Multivariate analysis confirmed fewer transfusions with neuraxial anesthesia, independent of patient comorbidities.

Conclusions:

  • Neuraxial anesthesia is associated with reduced perioperative transfusions and complications following THA.
  • Independent risk factors for transfusion include male gender, longer operative time, elevated INR, hypertension, metastatic cancer, and renal failure.
  • Neuraxial anesthesia offers a potentially safer and more cost-effective anesthetic technique for THA.