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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

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...
610
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

922
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...
922
General Anesthesia: Overview01:24

General Anesthesia: Overview

445
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...
445
Stages of General Anesthesia01:22

Stages of General Anesthesia

1.2K
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
1.2K
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

1.6K
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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Updated: Dec 5, 2025

Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
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Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis

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A case of total spinal anesthesia.

Gebrehiwot Asfaw1, Atalay Eshetie1

  • 1Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

International Journal of Surgery Case Reports
|October 14, 2020
PubMed
Summary

Total spinal anesthesia is a rare but serious complication of regional anesthesia, potentially causing breathing difficulties and loss of consciousness. Prompt recognition and intervention are crucial for patient safety during cesarean delivery.

Keywords:
Complete spinal blockHigh neuraxial blockObstetrics anesthesia Spinal anesthesiaTotal spinal

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Area of Science:

  • Anesthesiology
  • Obstetric Anesthesia
  • Neurosurgery

Background:

  • Spinal anesthesia is a preferred alternative to general anesthesia for urgent Cesarean deliveries, mitigating risks like difficult airways.
  • Regional anesthesia techniques are widely used in obstetrics due to their safety profile compared to general anesthesia.

Observation:

  • A case of unexpected total spinal anesthesia occurred during an emergency Cesarean section under spinal anesthesia for cephalopelvic disproportion.
  • The patient experienced sudden respiratory distress, hypotension, bradycardia, hypoxia, and loss of consciousness post-procedure.

Findings:

  • Total spinal anesthesia, though uncommon, can manifest during various regional anesthesia procedures near the vertebral column.
  • Key signs include rapid hypotension, motor blockade, respiratory compromise, and altered consciousness.

Implications:

  • This case underscores the importance of vigilance for total spinal anesthesia during neuraxial procedures.
  • Early detection and immediate resuscitation are vital to prevent severe maternal morbidity and ensure favorable outcomes.