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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

741
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...
741
General Anesthesia: Overview01:24

General Anesthesia: Overview

273
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
273
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

448
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
448
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

484
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...
484
Stages of General Anesthesia01:22

Stages of General Anesthesia

602
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
602
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

532
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...
532

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V-NOTES hysterectomy under spinal anaesthesia: A pilot study.

E C Gündoğdu, E Mat, Y Aboalhasan

    Facts, Views & Vision in Obgyn
    |October 7, 2022
    PubMed
    Summary

    Spinal anaesthesia is safe and effective for V-NOTES hysterectomy in selected patients. This approach reduces the need for additional pain medication and enhances the benefits of minimally invasive surgery.

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    Area of Science:

    • Gynecology
    • Anesthesiology
    • Minimally Invasive Surgery

    Background:

    • Spinal anaesthesia is underutilized in laparoscopic surgery despite evidence of comparable safety to general anaesthesia.
    • Early postoperative analgesia from spinal anaesthesia can reduce the need for additional pain management.
    • Vaginal Natural Orifice Transluminal Endoscopic Surgery (V-NOTES) offers benefits when combined with effective anaesthetic techniques.

    Purpose of the Study:

    • To assess the feasibility and safety of utilizing spinal anaesthesia for V-NOTES hysterectomy.
    • To enhance the advantages of minimally invasive surgery through combined V-NOTES and spinal anaesthesia.
    • To evaluate the potential for reduced analgesic requirements post-operatively.

    Main Methods:

    • A study involving patients undergoing V-NOTES hysterectomy for benign pelvic pathologies under spinal anaesthesia.
    • Administration of 12.5 mg 0.5% hyperbaric bupivacaine for spinal anaesthesia in the sitting position.
    • Monitoring of perioperative events and complications, with pain assessment using a visual analogue scale at 6, 12, and 24 hours post-surgery.

    Main Results:

    • All six patients completed the V-NOTES hysterectomy without conversion to laparoscopy or laparotomy.
    • No intraoperative or postoperative complications necessitated conversion from spinal to general anaesthesia.
    • No major perioperative incidents were recorded in any of the cases.

    Conclusions:

    • V-NOTES hysterectomy can be safely performed under spinal anaesthesia in carefully selected patients.
    • This technique maximizes the benefits of minimally invasive surgery by leveraging the early analgesic effects of spinal anaesthesia.
    • The findings support spinal anaesthesia as a viable option for V-NOTES procedures, potentially improving patient outcomes and reducing opioid reliance.