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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

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 Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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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: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

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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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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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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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Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
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Does regional anaesthesia improve outcome?

P M Hopkins1

  • 1Leeds Institute of Biomedical and Clinical Sciences, St James's University Hospital, Leeds, UK p.m.hopkins@leeds.ac.uk.

British Journal of Anaesthesia
|December 15, 2015
PubMed
Summary
This summary is machine-generated.

Regional anesthesia offers effective pain relief but doesn't consistently improve long-term surgical outcomes. Its impact on major complications is mixed, varying with patient and procedure factors.

Keywords:
deathregional anaesthesia, complicationsregional anaesthesia, outcomessurgery, complicationssurgery, outcomes

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Area of Science:

  • Anesthesiology
  • Surgical Outcomes Research

Background:

  • Regional anesthesia is known for effective postoperative pain management.
  • Recent studies increasingly utilize large database analyses to assess clinical outcomes.

Purpose of the Study:

  • To review current evidence on the impact of regional anesthesia on key clinical outcomes.
  • To evaluate the benefits and limitations of regional anesthesia in comparison to general anesthesia.

Main Methods:

  • Systematic review of recent evidence, emphasizing analyses of large databases.
  • Consideration of benefits and limitations of regional anesthesia techniques.
  • Comparative analysis with general anesthesia regarding specific complications.

Main Results:

  • Regional anesthesia provides effective short-term analgesia but generally does not improve longer-term surgical outcomes.
  • Evidence for reduced major complications with regional anesthesia is mixed; a small reduction in blood loss during joint arthroplasty is noted.
  • Effects on respiratory, infective, and cardiovascular complications are variable, with some data suggesting general anesthesia may protect against cognitive dysfunction.

Conclusions:

  • No general long-term outcome benefit is consistently observed with regional anesthesia.
  • Patient factors, surgical procedure, and anesthesiologist expertise likely influence outcomes.
  • Further research is needed to clarify the specific benefits and risks in diverse clinical scenarios.