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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.
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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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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Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
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Drugs Acting on Autonomic Ganglia: Blockers01:28

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Ganglionic blockers inhibit autonomic activity by blocking nicotinic receptors in the autonomic ganglia, suppressing impulse transmission. These blockers lack selectivity between sympathetic and parasympathetic ganglia and are ineffective as neuromuscular junction antagonists. They can be categorized into two groups:
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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

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Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
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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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Author Spotlight: Minimally Invasive Relief for Occipital Neuralgia at the Nuchal Line
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Peripheral nerve blocks for headache disorders.

Linford Fernandes1, Marc Randall1,2, Luis Idrovo3,2

  • 1Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Practical Neurology
|October 24, 2020
PubMed
Summary
This summary is machine-generated.

Peripheral nerve blocks offer a valuable treatment for headache disorders. This guide provides practical instructions and evidence for administering key nerve blocks, ensuring safe and effective patient care for headache practitioners.

Keywords:
Headachemigrainepain

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Area of Science:

  • Neurology
  • Pain Management
  • Anesthesiology

Background:

  • Headache is a common neurological condition and a frequent reason for hospital admissions.
  • Peripheral nerve blocks are utilized in headache and pain services, yet a comprehensive resource for their administration is lacking.
  • Effective management of headache disorders often involves targeted interventions.

Purpose of the Study:

  • To provide a practical, evidence-based guide for administering peripheral nerve blocks for headache disorders.
  • To create an accessible resource for healthcare practitioners managing patients with headaches.
  • To detail the safe delivery of specific nerve blocks relevant to headache treatment.

Main Methods:

  • Compilation of current evidence on peripheral nerve blocks for headache disorders.
  • Development of practical instructions for administering specific nerve blocks.
  • Inclusion of an audiovisual guide for procedural demonstration.
  • Documentation of adverse effects and potential complications.

Main Results:

  • Detailed instructions for performing greater and lesser occipital, supratrochlear, supraorbital, and auriculotemporal nerve blocks.
  • An audiovisual guide to supplement procedural instructions.
  • Information on the safety profile, including adverse effects and complications.
  • Evidence supporting the use of these blocks in various headache disorders.

Conclusions:

  • Peripheral nerve blocks are a practical intervention for headache disorders.
  • This resource provides essential guidance for safe and effective administration of nerve blocks.
  • Healthcare practitioners can use this guide to enhance patient care for headaches.