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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 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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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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Stages of General Anesthesia01:22

Stages of General Anesthesia

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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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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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Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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[Regional anesthesia - are the standards changing?]

T Volk1, C Kubulus2

  • 1Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Geb. Nr. 57, 66421, Homburg/Saar, Deutschland. thomas.volk@uniklinikum-saarland.de.

Der Anaesthesist
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PubMed
Summary
This summary is machine-generated.

Ultrasound has revolutionized regional anesthesia, enabling new injection techniques and improving nerve targeting for safer, more effective pain management. A German registry enhances safety by tracking outcomes and defining best practices.

Keywords:
Central nerve blockPeripheral nerve blockRegistrySafety

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Area of Science:

  • Anesthesiology
  • Medical Imaging
  • Pain Management

Background:

  • Regional anesthesia techniques have evolved significantly.
  • The integration of ultrasound technology has been a key driver of these advancements.
  • Established and novel regional anesthesia procedures are increasingly utilized.

Purpose of the Study:

  • To review the impact of ultrasound on regional anesthesia.
  • To highlight new ultrasound-guided injection techniques.
  • To discuss the role of a safety registry in regional anesthesia.

Main Methods:

  • Review of literature on ultrasound-guided regional anesthesia.
  • Description of novel fascial plane and nerve targeting techniques.
  • Analysis of data from a regional anesthesia safety registry.

Main Results:

  • Ultrasound allows for precise nerve identification and improved targeting (e.g., interscalene, femoral blocks).
  • New techniques involve injecting local anesthetics into fascial or muscular planes (e.g., cervical plexus, truncal blocks).
  • Ultrasound assists in neuraxial blocks, especially in challenging anatomies.

Conclusions:

  • Ultrasound has transformed regional anesthesia by enhancing precision and enabling new blockades.
  • A decade-long safety registry provides valuable data for improving regional anesthesia practices and patient safety.
  • The registry serves as a benchmark for quality comparison across institutions.