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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

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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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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Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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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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Related Experiment Video

Updated: Oct 15, 2025

Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache
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Peripheral Nerve Blocks for Postdural Puncture Headache: A New Solution for an Old Problem?

Luca Gregorio Giaccari1, Caterina Aurilio1, Francesco Coppolino1

  • 1Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.

In Vivo (Athens, Greece)
|October 26, 2021
PubMed
Summary

Peripheral nerve blocks offer a safe and effective alternative for treating postdural puncture headache (PDPH). This systematic review found these blocks provide significant pain relief, potentially reducing the need for traditional epidural blood patches.

Keywords:
Postdural puncture headachegreater occipital nerve blocklesser occipital nerve blockreviewsphenopalatine ganglion block

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Area of Science:

  • Anesthesiology
  • Neurology
  • Pain Management

Background:

  • Postdural puncture headache (PDPH) is a recognized complication following regional anesthesia.
  • Epidural blood patch (EBP) is the established treatment, but alternatives are being explored.

Purpose of the Study:

  • To systematically review the efficacy and safety of peripheral nerve blocks for PDPH treatment.
  • To assess peripheral nerve blocks as an alternative to EBP.

Main Methods:

  • Systematic search of major databases for studies on regional anesthesia and PDPH.
  • Inclusion of 19 studies with 221 patients.

Main Results:

  • Peripheral nerve blocks (sphenopalatine, greater/lesser occipital) were performed.
  • All patients reported reduced pain (Numeric Rating Scale <4) post-block.
  • No major adverse events were reported; 30 patients eventually required EBP.

Conclusions:

  • Peripheral nerve blocks are a viable analgesic option for managing PDPH.
  • This is the first systematic review on this specific application of peripheral nerve blocks.