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Related Concept Videos

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 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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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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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: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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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: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
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Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
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[Neuraxial anaesthesia and NOACs].

T Standl1

  • 1Klinik für Anästhesie, Operative Intensiv- u. Palliativmedizin, Städtisches Klinikum Solingen gGmbH, Gotenstraße 1, 42653, Solingen, Deutschland. standl@klinikumsolingen.de.

Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|January 12, 2017
PubMed
Summary
This summary is machine-generated.

Neuraxial blockade offers benefits for surgical patients with cardiovascular risks. Careful management of new oral anticoagulants (NOACs) is essential for safe neuraxial anesthesia and improved postoperative outcomes.

Keywords:
Cardiovascular diseasesEpidural analgesiaPerioperative managementPostoperative periodTreatment outcome

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Surgical Care

Background:

  • Cardiovascular comorbidities are common in surgical patients, impacting outcomes.
  • Neuraxial blockades can reduce perioperative complications.
  • New oral anticoagulants (NOACs) necessitate careful management during neuraxial procedures.

Purpose of the Study:

  • To highlight the advantages of neuraxial anesthesia and analgesia in high-risk cardiovascular patients.
  • To outline the perioperative management of NOACs in this patient group.

Main Methods:

  • Literature review of PubMed (last 25 years).
  • Presentation of the German S1 guideline on neuraxial anesthesia and antithrombotic medication.

Main Results:

  • Thoracic epidural anesthesia/analgesia improves outcomes in high-risk surgical patients.
  • Adherence to DGAI guidelines and interdisciplinary consultation are crucial for managing NOACs and preventing complications.

Conclusions:

  • Neuraxial blockades are feasible and beneficial for cardiovascular risk patients on NOACs.
  • Following guidelines ensures improved postoperative outcomes.