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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.
One of the advantages of...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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Blood and Nerve Supply to the Bones01:29

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Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
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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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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
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Peripheral nerve blocks for hip fractures.

Joanne Guay1, Martyn J Parker2, Richard Griffiths3

  • 1Department of Anesthesiology, Faculty of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada.

The Cochrane Database of Systematic Reviews
|May 12, 2017
PubMed
Summary
This summary is machine-generated.

Peripheral nerve blocks significantly reduce pain after hip fracture surgery within 30 minutes of placement. Evidence also suggests reduced pneumonia risk and faster mobilization, with cost savings for single-shot blocks.

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Area of Science:

  • Anesthesiology and Pain Management
  • Orthopedic Surgery
  • Evidence-Based Medicine

Background:

  • Hip fractures are a common cause of severe pain and immobility in adults.
  • Nerve blocks using local anesthetics have been explored for pain management post-hip fracture surgery.
  • This review is an updated analysis of existing evidence on peripheral nerve blocks for hip fracture care.

Purpose of the Study:

  • To evaluate the efficacy of peripheral nerve blocks for analgesia in hip fracture surgery.
  • To assess nerve blocks as preoperative, postoperative, or supplementary anesthetic agents.
  • To incorporate new studies and adhere to updated Cochrane review standards.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched multiple databases including CENTRAL, MEDLINE, Embase, and CINAHL up to August 2016.
  • Included RCTs involving adults (≥16 years) with hip fractures receiving nerve blocks.

Main Results:

  • High-quality evidence shows peripheral nerve blocks reduce pain on movement within 30 minutes (SMD -1.41).
  • Moderate evidence indicates a reduced risk of pneumonia (RR 0.41, NNTB 7) and faster mobilization (11.25 hours sooner).
  • No significant difference in acute confusional state, myocardial ischemia, or death; cost of analgesics was lower with single-shot blocks.

Conclusions:

  • Peripheral nerve blocks provide effective and rapid pain relief following hip fracture surgery.
  • Nerve blocks are associated with improved patient outcomes, including reduced pneumonia and earlier mobilization.
  • Single-shot peripheral nerve blocks offer a cost-effective analgesic strategy.