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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 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: 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: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

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The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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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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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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Recent technological advancements in regional anesthesia.

Sudipta Sen1, Michelle Ge1, Amit Prabhakar2

  • 1Department of Anesthesiology, McGovern Medical School, University of Texas Health Sciences Centre at Houston, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, USA.

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

Technological advancements, including ultrasound (US) and echogenic needles, have significantly improved regional anesthesia outcomes. Further research is needed to evaluate novel technologies like 3D/4D US and robotics for enhanced patient care.

Keywords:
nerve blocksoptical spectroscopyregional anesthesiaultrasound

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Area of Science:

  • Anesthesiology
  • Medical Imaging
  • Pain Management

Background:

  • Regional anesthesia techniques have evolved significantly over the past two decades.
  • Early regional anesthesia lacked precision, leading to variable outcomes and limited support.
  • Technological progress has revolutionized the field, enhancing safety and efficacy.

Purpose of the Study:

  • To review the impact of technological advancements on regional anesthesia.
  • To highlight innovations improving needle visualization and placement accuracy.
  • To discuss emerging technologies and their potential in regional anesthesia.

Main Methods:

  • Review of recent technological developments in regional anesthesia.
  • Discussion of ultrasound (US) technology improvements (picture quality, portability).
  • Exploration of advanced US techniques (3D/4D US, magnetically guided needles) and echogenic needles.

Main Results:

  • Ultrasound technology has become more affordable, with improved image quality and portability.
  • Echogenic needles enhance needle visualization, increasing physician confidence and reducing procedure time.
  • Emerging technologies like 3D/4D US, magnetic guidance, and robotics show promise for improving success rates and patient safety.

Conclusions:

  • Technological innovations, particularly in ultrasound, have dramatically improved regional anesthesia outcomes.
  • Advanced visualization and guidance techniques are crucial for optimizing patient care and reducing complications.
  • Further research and clinical trials are essential to validate the efficacy of novel regional anesthesia technologies.