Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

714
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...
714
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

477
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...
477
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

511
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...
511

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Association Between Amyloid Deposition and Collagen-to-Elastin Ratio in the Ligamentum Flavum: A Machine Learning Histologic Study in Matched Groups.

Neurosurgery·2026
Same author

Rediscovering the origins of Kocher's point.

Journal of neurosurgery·2026
Same author

GLP-1 Receptor Agonists: Clinical Considerations and Risk Management for Patients Undergoing Ophthalmic Surgery.

Ophthalmic surgery, lasers & imaging retina·2026
Same author

Anesthesiologist attitudes toward Spinal anesthesia in lumbar spine Surgery: National survey findings and implications for Patient-Centered Care.

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia·2025
Same author

Assessing a dose-response relationship: Preoperative opioid daily MME and duration on lumbar spine surgery patient-reported outcomes.

Clinical neurology and neurosurgery·2025
Same author

Safety of non-osseous union of type II odontoid fractures-a multi-institutional cohort study.

The spine journal : official journal of the North American Spine Society·2025

Related Experiment Video

Updated: Aug 12, 2025

Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
08:38

Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique

Published on: July 15, 2021

3.4K

A Second Prone Dose Algorithm for Patients Undergoing Spinal Anesthesia During Thoracolumbar Surgeries.

Andy Y Wang1, Michelle Olmos1, Tameem Ahsan1

  • 1Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts, USA.

Operative Neurosurgery (Hagerstown, Md.)
|January 26, 2023
PubMed
Summary

A new algorithm for spinal anesthesia in spine surgery successfully increased the success rate to 99.5%. This approach, using an additional prone dose, avoided intraoperative conversion to general anesthesia and had no associated complications.

More Related Videos

Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine
09:00

Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine

Published on: October 10, 2017

12.9K
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

1.7K

Related Experiment Videos

Last Updated: Aug 12, 2025

Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
08:38

Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique

Published on: July 15, 2021

3.4K
Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine
09:00

Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine

Published on: October 10, 2017

12.9K
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

1.7K

Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Spinal Surgery

Background:

  • Spinal anesthesia offers advantages over general anesthesia for lumbar surgeries but faces challenges due to potential intraprocedural failure.
  • Intraoperative conversion to general anesthesia is a significant concern limiting wider adoption of spinal anesthesia in spine procedures.

Purpose of the Study:

  • To introduce and evaluate a novel algorithm for administering an additional prone dose of spinal anesthesia when the initial dose is insufficient.
  • To determine the efficacy and safety of this supplemental dosing strategy in thoracolumbar surgeries.

Main Methods:

  • A prospective enrollment of 422 patients undergoing thoracolumbar surgeries under spinal anesthesia.
  • Retrospective data collection from electronic health records to analyze outcomes.

Main Results:

  • Sixteen patients (3.8%) required a second prone dose; one refused and was converted to general anesthesia preoperatively.
  • Following the additional dose, only 2 patients required preoperative conversion, leading to an overall spinal anesthesia success rate of 99.5%.
  • No intraoperative conversions to general anesthesia occurred. Patients receiving the second dose experienced no spinal headache, DVT, pneumonia, UTI, or other significant complications.

Conclusions:

  • The additional prone dose algorithm significantly enhances the success rate of spinal anesthesia in thoracolumbar surgeries to 99.5%.
  • This strategy effectively prevents intraoperative conversion to general anesthesia without introducing adverse events or complications.
  • Further research is warranted to identify patient-specific risk factors for inadequate spinal anesthesia analgesia.