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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

517
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...
517
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

625
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...
625
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

857
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...
857
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

963
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...
963

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Related Experiment Video

Updated: Sep 29, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
03:14

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy

Published on: January 31, 2025

647

Epidural Needle Guidance Using Viscoelastic Tissue Response.

Benjamin Scott Simpson1,2, Michael Burns3, Robert P Dick1

  • 1Department of Electrical Engineering and Computer ScienceUniversity of Michigan Ann Arbor MI 48109 USA.

IEEE Journal of Translational Engineering in Health and Medicine
|March 23, 2022
PubMed
Summary
This summary is machine-generated.

This study developed a system using mechanical probing and machine learning to detect bone during epidural needle placement. While accurate within 3mm, it requires further advances for 5mm clinical forewarning.

Keywords:
Epiduralbiomedical engineeringmachine learningneedle placementviscoelastic response

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Area of Science:

  • Biomedical Engineering
  • Medical Devices
  • Translational Research

Background:

  • Epidural needle placement is critical for anesthesia and pain management.
  • Accidental bone contact during epidural procedures can lead to complications.
  • Current methods lack real-time feedback to prevent bone strikes.

Purpose of the Study:

  • To design, prototype, and test a system for real-time viscoelastic tissue response measurement.
  • To aid clinicians by providing an alert before epidural needles contact bone.
  • To assess the feasibility of non-destructive mechanical probing for tissue differentiation.

Main Methods:

  • Utilized an intra-needle probe to mechanically stimulate tissue at the needle tip during insertion.
  • Collected viscoelastic response data periodically during needle advancement.
  • Employed a machine-learning algorithm to analyze stimulation data and detect proximity to bone.

Main Results:

  • The system reliably identified bone contact and proximity within 3 mm in ex vivo pig spine tests.
  • Demonstrated successful differentiation of materials at and in front of the needle tip.
  • The system did not achieve the desired 5 mm forewarning for clinical application.

Conclusions:

  • The developed technique shows promise for tissue differentiation during needle placement.
  • Further technical advancements are needed to achieve the required forewarning distance for clinical epidural procedures.
  • The system's feasibility for improving epidural needle placement safety warrants further investigation.