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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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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

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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Regional Terms01:12

Regional Terms

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Regional terms describe anatomy by dividing the body parts into different regions that contain structures involved in contributing similar functions. Using these terms helps increase the accurate description and identification of the particular region of interest or region affected by the disease.
Primarily, the human body has two major regions, the axial and appendicular regions. The axial region comprises regions from the head to the abdomen and makes up the central body axis. In contrast,...
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Updated: Jan 3, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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REGIONAL ANAESTHESIA IN THORACIC AND ABDOMINAL SURGERY.

Vesna Novak-Jankovič1, Jasmina Markovič-Božič1

  • 1Clinical department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Acta Clinica Croatica
|November 20, 2019
PubMed
Summary

Regional anesthesia techniques, like thoracic epidural analgesia and transversus abdominis plane block, offer immune protection during surgery. Multimodal pain management is key for optimal perioperative care.

Keywords:
abdominal surgeryregional anaesthesiathoracic surgery

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Area of Science:

  • Anesthesiology
  • Surgical Immunology
  • Pain Management

Background:

  • Surgical procedures induce tissue damage, triggering systemic inflammatory responses that affect endocrine and metabolic functions.
  • Anesthesia and pain can impair immune system performance, necessitating effective perioperative management strategies.
  • Regional anesthesia techniques provide afferent nerve blockade, mediating crucial immune protection during and after surgery.

Purpose of the Study:

  • To review current perioperative pain management strategies, focusing on regional anesthesia techniques.
  • To compare the efficacy and side effect profiles of different regional anesthesia methods in surgical patients.
  • To highlight the role of multimodal analgesia in optimizing outcomes following minimally invasive and traditional surgery.

Main Methods:

  • Review of current literature on regional anesthesia and perioperative pain management.
  • Comparison of thoracic epidural analgesia, thoracic paravertebral block, and transversus abdominis plane block.
  • Analysis of pain control, hemodynamic stability, and hospital stay associated with different analgesic techniques.

Main Results:

  • Thoracic epidural analgesia and thoracic paravertebral block are effective for thoracic and abdominal surgery pain relief.
  • Central regional blocks may be contraindicated in patients with coagulation disorders.
  • Transversus abdominis plane block demonstrated comparable postoperative pain relief to epidural analgesia, with improved hemodynamic stability and shorter hospital stays.

Conclusions:

  • Multimodal analgesia, combining regional and systemic techniques, represents the most appropriate perioperative pain management strategy.
  • The shift towards minimally invasive surgery necessitates evolving, less aggressive pain treatment approaches.
  • Further research is required to establish definitive recommendations for perioperative pain management protocols.