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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 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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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: 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

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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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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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REGIONAL ANESTHESIA FOR NEUROSURGERY.

Dinko Tonković1, Daniela Bandić Pavlović1, Robert Baronica1

  • 11School of Medicine, University of Zagreb; 2University Hospital Zagreb, Department of Anesthesiology, Reanimatology and Intensive care.

Acta Clinica Croatica
|November 20, 2019
PubMed
Summary

Maintaining hemodynamic stability during neurosurgery is crucial. Regional anesthesia may offer benefits by reducing pain and anesthetic drug use, aiding faster patient recovery and improving outcomes.

Keywords:
hemodynamic stabilityneurosurgerypostoperative analgesiaregional anesthesia

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Area of Science:

  • Neurosurgery Anesthesia
  • Cerebral Perfusion Management
  • Regional Anesthesia Techniques

Background:

  • Optimal cerebral perfusion and oxygenation are vital during neurosurgery.
  • General anesthesia, while common, can lead to undesirable hemodynamic fluctuations.
  • These fluctuations pose risks, particularly for patients with high intracranial pressure or brain edema.

Purpose of the Study:

  • To explore the potential benefits of regional anesthesia in neurosurgery.
  • To assess regional anesthesia's role in managing hemodynamic stability and anesthetic drug requirements.
  • To evaluate its impact on patient recovery and postoperative pain.

Main Methods:

  • Review of current anesthetic practices in neurosurgery.
  • Analysis of the physiological effects of general versus regional anesthesia on cerebral perfusion.
  • Evaluation of pain management and recovery profiles associated with regional techniques for scalp and spine.

Main Results:

  • Regional anesthesia techniques may reduce pain stimuli and hemodynamic variability.
  • These techniques can potentially spare the use of general anesthetic agents.
  • Regional anesthesia offers effective postoperative pain relief, particularly beneficial after spinal surgery.

Conclusions:

  • Regional anesthesia presents a viable alternative or adjunct in neurosurgical procedures.
  • It may contribute to improved hemodynamic control and faster emergence from anesthesia.
  • Enhanced postoperative pain management is a significant advantage of regional techniques.