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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.
One of the advantages of...
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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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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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Arteries of the Upper Limbs01:12

Arteries of the Upper Limbs

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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
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[Ultrasound-guided regional anesthesia: best practice upper extremities].

T Ermert1, C Goeters2

  • 1Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland. ermert@uni-muenster.de.

Der Anaesthesist
|November 19, 2020
PubMed
Summary

Regional anesthesia for upper extremities is standard care. Choosing the right procedure requires careful consideration and adaptation to individual patient needs due to many options.

Keywords:
AnatomyArmLocal anestheticsNerve blockPatient satisfaction

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Area of Science:

  • Anesthesiology
  • Regional Anesthesia

Background:

  • Regional anesthesia for upper extremities is a standard procedure for anesthesiologists.
  • The increasing number of available regional anesthesia techniques presents challenges in selection.
  • The efficacy of regional anesthesia is well-established but requires precise application.

Purpose of the Study:

  • To highlight the challenges in selecting the appropriate regional anesthesia technique for upper extremity procedures.
  • To emphasize the importance of tailoring anesthetic procedures to individual patient requirements.

Main Methods:

  • Review of current regional anesthesia techniques for the upper extremities.
  • Analysis of factors influencing procedure selection.
  • Case-based considerations for adapting techniques.

Main Results:

  • A wide array of regional anesthesia options exists for upper extremity procedures.
  • Optimal patient outcomes depend on careful selection and customization of the anesthetic technique.
  • Standardization of principles, with individual adaptation, is key.

Conclusions:

  • Regional anesthesia for the upper extremities is a cornerstone of modern anesthesiology.
  • Effective application necessitates a thorough understanding of available options and patient-specific factors.
  • Personalized approach to regional anesthesia ensures optimal patient care.