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Related Concept Videos

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 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

941
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...
941
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

1.1K
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...
1.1K
General Anesthesia: Overview01:24

General Anesthesia: Overview

458
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...
458
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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Related Experiment Video

Updated: Dec 10, 2025

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
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Wide-Awake Surgery With Local Anesthesia and Epinephrine Is Safe.

Asif M Ilyas, John D Jennings, Lauren Banner

    Orthopedics
    |September 4, 2020
    PubMed
    Summary
    This summary is machine-generated.

    Epinephrine is safe for wide-awake hand surgery. A study of over 4000 procedures found no complications, demonstrating its safety for hand and upper extremity surgeries performed with local anesthesia.

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    Area of Science:

    • Orthopedics
    • Anesthesiology

    Background:

    • Wide-awake hand surgery utilizes local anesthetic and epinephrine.
    • Concerns exist regarding the safety of epinephrine in hand surgery.

    Purpose of the Study:

    • To evaluate the safety of epinephrine in wide-awake hand and upper extremity surgery.
    • To determine if epinephrine is safe for a broad range of hand and upper extremity procedures.

    Main Methods:

    • Retrospective chart review of 4287 wide-awake procedures over 4 years.
    • Procedures performed by 2 surgeons using local anesthesia with epinephrine.
    • Data collected on patient demographics, procedure type, and epinephrine-related complications.

    Main Results:

    • No epinephrine-related complications were reported in 4287 procedures.
    • Zero instances of tissue necrosis, phentolamine reversal, anaphylaxis, or readmissions.
    • No patients required conversion to general anesthesia or monitored anesthesia care.

    Conclusions:

    • Epinephrine is safe for wide-awake hand and upper extremity surgery.
    • The study confirms the safety of epinephrine in over 4000 consecutive cases.
    • Epinephrine can be safely used with local anesthesia for various hand surgeries.