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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

693
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...
693
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

546
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...
546
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

346
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
346
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

547
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...
547
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 Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

917
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...
917

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Error traps in pediatric regional anesthesia.

Melissa M Masaracchia1, Rani A Sunder2, David M Polaner2

  • 1Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.

Paediatric Anaesthesia
|August 16, 2021
PubMed
Summary
This summary is machine-generated.

This study highlights five common error traps in pediatric ultrasound-guided regional anesthesia. Recognizing and mitigating these errors promotes safety and improves patient outcomes in regional anesthesia.

Keywords:
childnerve block/methodsnerve block/trendsregional painultrasonography

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Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Regional Anesthesia

Background:

  • Ultrasound-guided nerve blocks offer significant benefits for perioperative pain management in children.
  • Benefits include reduced opioid use, shorter hospital stays, and improved patient satisfaction.
  • However, potential error traps can compromise the safety and efficacy of these blocks.

Purpose of the Study:

  • To promote a culture of safety in pediatric regional anesthesia.
  • To identify and discuss five common, avoidable error traps in ultrasound-guided nerve blocks for pediatric patients.

Main Methods:

  • Review of common error traps in pediatric regional anesthesia.
  • Focus on strategies to mitigate identified risks.
  • Emphasis on the importance of recognizing and addressing specific challenges.

Main Results:

  • Five common error traps were identified: incorrect block site confirmation, suboptimal ultrasound imaging/artifact recognition, misjudgment of regional anesthesia suitability, inadequate use of alternative imaging, and failure to account for abnormal anatomy in disease states.
  • These errors are avoidable with proper awareness and technique.

Conclusions:

  • Awareness of common error traps is crucial for safe pediatric regional anesthesia.
  • Implementing strategies to mitigate these risks enhances patient safety and optimizes outcomes.
  • Pediatric regionalists must be cognizant of potential pitfalls and employ appropriate techniques.