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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 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.
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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Epistaxis01:30

Epistaxis

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Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
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Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
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Related Experiment Video

Updated: Mar 22, 2026

The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects
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Epidural Blood Patch Using Manometry for Sinking Skin Flap Syndrome.

James D Turner1, Justin L Farmer, Sean W Dobson

  • 1From the Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.

A & a Case Reports
|April 15, 2016
PubMed
Summary

This case report details a patient with traumatic subarachnoid hemorrhage who developed sinking skin flap syndrome. An epidural blood patch successfully treated the condition, improving neurological status.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Trauma Surgery

Background:

  • A 55-year-old male with chronic back pain and cocaine abuse experienced a traumatic subarachnoid hemorrhage after a fall.
  • The patient required decompressive hemicraniectomy and cranioplasty, complicated by an epidural abscess necessitating a repeat craniectomy.

Observation:

  • Post-cranioplasty, the patient developed sinking skin flap syndrome, characterized by altered mental status and increased midline shift.
  • Despite Trendelenburg positioning and fluid management, the patient's neurological condition deteriorated.

Findings:

  • An epidural blood patch was administered using manometry in the epidural space.
  • Following the epidural blood patch, the patient's neurological status significantly improved.

Implications:

  • This case highlights the efficacy of epidural blood patching in managing sinking skin flap syndrome after neurosurgery.
  • Successful treatment allowed for definitive cranioplasty and improved the patient's functional independence and communication abilities.