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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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Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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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 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...
1.7K
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

2.6K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
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Related Experiment Video

Updated: Jan 2, 2026

Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve
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Newer nerve blocks in pediatric surgery.

Alan D Kaye1, Jeremy B Green2, Kelly S Davidson3

  • 1Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA 70112, United States.

Best Practice & Research. Clinical Anaesthesiology
|December 4, 2019
PubMed
Summary

Pediatric regional anesthesia, including nerve blocks and catheters, is increasingly used due to its safety and efficacy. Further studies are needed to confirm its benefits in multimodal analgesia.

Keywords:
nerve blockspediatricpediatric regional anesthesiaregional anesthesia

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Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia Techniques

Background:

  • Pediatric regional anesthesia is experiencing increased utilization.
  • This rise is linked to the emphasis on perioperative multimodal analgesia.
  • Growing evidence supports the safety and effectiveness of these procedures in children.

Purpose of the Study:

  • To discuss current trends in pediatric regional anesthesia.
  • To highlight both novel and established nerve block techniques for pediatric patients.

Main Methods:

  • Review of current literature and data on pediatric regional anesthesia.
  • Focus on ultrasound-guided techniques and their impact.
  • Consideration of studies from networks like the Pediatric Regional Anesthesia Network (PRAN).

Main Results:

  • Pediatric nerve block performance is on the rise.
  • Ultrasound guidance has enhanced the safety and efficacy of nerve blocks and catheters.
  • Major complications are rare, with overall safety demonstrated in pediatric populations.

Conclusions:

  • Continued expansion of pediatric regional anesthesia is expected.
  • Further large-scale prospective studies are essential.
  • Demonstrating ongoing efficacy and safety is crucial for multimodal analgesia strategies.