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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

954
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...
954
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

1.1K
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
1.1K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

565
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...
565
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

958
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...
958
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

566
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
566
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

756
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...
756

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Related Experiment Video

Updated: Nov 5, 2025

Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion
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Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion

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Changes in the microvascular reactivity during spinal anesthesia.

Ah-Reum Cho1, Hyae-Jin Kim1, Hyeon-Jeong Lee1

  • 1Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea; Department of Anesthesia and Pain Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

Microvascular Research
|May 13, 2021
PubMed
Summary
This summary is machine-generated.

Spinal anesthesia increased tissue oxygen saturation but decreased microvascular reperfusion rates. This suggests complex effects on microvascular function during anesthesia.

Keywords:
MicrocirculationNear-infraredSpectroscopySpinal anesthesia

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Area of Science:

  • Anesthesiology and Perioperative Medicine
  • Physiology
  • Medical Devices and Instrumentation

Background:

  • Anesthesia can alter microcirculation and tissue oxygen saturation (StO2).
  • Near-infrared spectroscopy (NIRS) and vascular occlusion tests (VOT) are tools to assess microvascular function.
  • Understanding these changes is crucial for patient safety during surgery.

Purpose of the Study:

  • To investigate the impact of spinal anesthesia on tissue oxygen saturation (StO2) and microvascular reactivity.
  • To utilize near-infrared spectroscopy (NIRS) and vascular occlusion tests (VOT) to measure these changes.
  • To assess alterations in StO2 during VOT before and after spinal anesthesia.

Main Methods:

  • Prospective observational study involving 51 patients undergoing elective surgery.
  • Measurement of lower extremity StO2 using NIRS during VOT.
  • Comparison of StO2 parameters (baseline, minimum, maximum, occlusion slope, reperfusion slope) before and after intrathecal injection.

Main Results:

  • Spinal anesthesia significantly increased baseline, minimum, and maximum StO2 values during VOT.
  • No significant changes were observed in the occlusion slope or ischemic stimulus.
  • A significant decrease in the reperfusion slope was noted after spinal anesthesia.

Conclusions:

  • Spinal anesthesia appears to increase tissue oxygenation while simultaneously reducing microvascular reperfusion rates.
  • These findings present a complex picture of spinal anesthesia's effects on microvascular function.
  • Further research is needed to elucidate the clinical implications of these contradictory effects.