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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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Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

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Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
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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: Adverse Effects01:12

Local Anesthetics: Adverse Effects

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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.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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Drug Delivery: Parenteral Route01:29

Drug Delivery: Parenteral Route

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The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Updated: Feb 26, 2026

Lumbar Intrathecal Injection of Gene Therapy Vectors for Central Nervous System Targeting in Mice and Rats
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[Spinal injection : risks and side effects].

Evangelia Passia1, Stéphane Genevay2

  • 1Service de médecine interne générale, HUG, 1211 Genève 14.

Revue Medicale Suisse
|July 19, 2017
PubMed
Summary
This summary is machine-generated.

Spinal injections for chronic pain lack proven efficacy for many conditions and carry risks. Serious side effects, though rare, necessitate thorough patient discussion and informed consent before treatment.

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Area of Science:

  • Pain Management
  • Neurosurgery
  • Pharmacology

Background:

  • Spinal injections are frequently used for chronic spinal pain.
  • The efficacy of these injections is questionable for numerous conditions.
  • Comprehensive reporting of side effects in existing literature is lacking.

Purpose of the Study:

  • To evaluate the efficacy and safety of spinal injections for chronic pain.
  • To highlight the underreported side effects associated with spinal injections.
  • To emphasize the importance of informed consent regarding potential risks.

Main Methods:

  • Literature review on spinal injection efficacy and side effects.
  • Analysis of reported complications, including infections, hematomas, and infarctions.
  • Assessment of the link between intravascular corticoid injection and adverse events.

Main Results:

  • Efficacy of spinal injections is dubious for most chronic spinal pain conditions.
  • Reported side effects range from transient issues to severe, lethal complications.
  • Serious adverse events include infection, hematoma, and central/spinal cord infarctions.
  • Intravascular injection of corticoids is a potential cause of severe complications.

Conclusions:

  • Spinal injections should be approached with caution due to uncertain efficacy and potential severe risks.
  • Thorough discussion of all potential side effects, including rare but serious ones, is crucial before patient prescription.
  • Informed consent forms must explicitly mention the risks associated with spinal injections.