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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 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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Patient-centered Care01:13

Patient-centered Care

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Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
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Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

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In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Related Experiment Video

Updated: Jan 28, 2026

Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
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Transperineal Prostate Biopsies Using Local Anesthesia: Experience with 1,287 Patients. Prostate Cancer Detection

Veselina Stefanova1,2, Roger Buckley2, Stanley Flax2

  • 1Western University , London , Ontario , Canada.

The Journal of Urology
|March 6, 2019
PubMed
Summary

Transperineal prostate biopsy under local anesthesia is a safe and effective method for diagnosing prostate cancer, detecting anterior zone cancers, and is well-tolerated by patients.

Keywords:
anesthesiabiopsydiagnosislocalpainprostatic neoplasms

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Related Experiment Videos

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Area of Science:

  • Urology
  • Oncology
  • Medical Procedures

Background:

  • Prostate cancer diagnosis relies on accurate biopsy techniques.
  • Transrectal biopsy has been the traditional method, but carries risks.
  • Transperineal biopsy offers a potential alternative with improved safety and tolerability.

Purpose of the Study:

  • To evaluate the experience with transperineal prostate biopsy.
  • To determine the cancer diagnosis rate, complication profile, and patient tolerability.
  • To assess its feasibility as an alternative to transrectal biopsy.

Main Methods:

  • Retrospective analysis of 1,287 consecutive patients undergoing transperineal prostate biopsy.
  • Procedures performed using local anesthesia since October 2016.
  • Data collected on prebiopsy characteristics, cancer detection, complications, and tolerability scores.

Main Results:

  • A cancer detection rate of 49.8% was observed.
  • Clinically significant cancer found in 385 patients; 9.7% had anterior zone-only findings.
  • Low complication rates: 1.6% urinary retention, 0.3% suspected infection; well-tolerated by patients.

Conclusions:

  • Transperineal prostate biopsy under local anesthesia is a feasible and effective method for prostate cancer detection.
  • It offers an acceptable cancer detection rate, including anterior zone cancers.
  • It is a safer alternative with low complication risks and good patient tolerance, potentially becoming a standard diagnostic modality.