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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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Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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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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Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

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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.
Although all competitive neuromuscular blockers are designed...
749
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

654
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
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Related Experiment Video

Updated: Dec 2, 2025

Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
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Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis

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Bilateral Erector Spinae Blocks Decrease Perioperative Opioid Use After Pediatric Cardiac Surgery.

Nathalie Roy1, Morgan L Brown2, M Fernanda Parra1

  • 1Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.

Journal of Cardiothoracic and Vascular Anesthesia
|November 3, 2020
PubMed
Summary

Continuous bilateral erector spinae blocks reduced opioid use in children after cardiac surgery. This pain management technique shows promise for improving recovery and patient satisfaction in pediatric cardiac surgery patients.

Keywords:
ERASEnhanced Recovery After Surgeryopioidpediatric cardiac surgerypostoperative painregional anesthesia

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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Post-sternotomy pain is a significant concern in pediatric cardiac surgery.
  • Effective pain management is crucial for recovery and patient outcomes.

Purpose of the Study:

  • To assess the feasibility and efficacy of continuous bilateral erector spinae blocks for managing post-sternotomy pain in pediatric cardiac surgery.
  • To compare opioid consumption between patients receiving erector spinae blocks and a control group.

Main Methods:

  • A prospective cohort study involving 10 children (ages 5-17) undergoing cardiac surgery.
  • Ultrasound-guided bilateral erector spinae blocks with ropivacaine infusion were administered postoperatively.
  • Patients were matched 1:2 to a control group, and statistical analyses (logistic regression, generalized linear models) were used.

Main Results:

  • Bilateral erector spinae blocks were feasible and safe, with no major adverse events.
  • Opioid use at 48 hours post-surgery was significantly reduced in the block group (0.81 mg/kg) compared to the control group (1.10 mg/kg).
  • No significant differences were observed in recovery metrics, length of stay, or complications.

Conclusions:

  • Continuous bilateral erector spinae blocks are a viable option for reducing opioid requirements in pediatric cardiac surgery.
  • Further research with larger cohorts is necessary to confirm benefits in recovery and patient satisfaction.