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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

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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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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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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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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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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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[Lower limb postoperative analgesia evolution : Time for sensitive blocks].

P Laurent1, J C Cres1

  • 1Service d'Anesthésie, Centre Hospitalier du Bois de l'Abbaye, Seraing, Belgique.

Revue Medicale De Liege
|December 14, 2019
PubMed
Summary
This summary is machine-generated.

Peripheral nerve blocks offer superior postoperative pain relief for knee and foot surgery. Ultrasound-guided distal nerve blocks provide effective analgesia without motor impairment, enabling faster patient recovery and same-day procedures.

Keywords:
BlocksDistalIPACKNerveAnalgesia

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Area of Science:

  • Anesthesiology
  • Surgical Pain Management

Background:

  • Peripheral nerve blocks are standard for postoperative analgesia in knee and foot surgery.
  • Echography has enabled precise distal nerve blocks, offering advantages over general anesthesia.
  • Proximal blocks provided superior analgesia with fewer side effects than general anesthesia but caused motor blockade.

Purpose of the Study:

  • To evaluate the efficacy of distal nerve blocks in comparison to proximal blocks.
  • To assess the impact of distal nerve blocks on patient recovery and mobility.
  • To determine the feasibility of same-day surgical procedures with advanced nerve block techniques.

Main Methods:

  • Utilized ultrasound-guided techniques for peripheral nerve blocks.
  • Compared analgesia and side effect profiles of proximal versus distal nerve blocks.
  • Assessed patient mobility and recovery post-procedure.

Main Results:

  • Distal nerve blocks provide analgesia comparable to proximal blocks.
  • Distal blocks avoid motor blockade, facilitating early ambulation.
  • Patients experienced fewer side effects compared to general anesthesia and central blocks.

Conclusions:

  • Distal, ultrasound-guided nerve blocks offer effective, opioid-sparing analgesia for lower limb surgery.
  • These techniques allow for rapid rehabilitation and same-day discharge.
  • Nerve blocks are a safe and effective alternative to general anesthesia for knee and foot procedures.