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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

501
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...
501
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

1.1K
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...
1.1K
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

697
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...
697
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

474
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...
474
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

821
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
821
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

497
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
497

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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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Recent advancements in regional anaesthesia.

Madhuri S Kurdi1, Pushpa Agrawal2, Parna Thakkar3

  • 1Department of Anaesthesiology, Karnataka Institute of Medical Sciences (KIMS), Hubli, Karnataka, India.

Indian Journal of Anaesthesia
|March 27, 2023
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Summary

Advancements in regional anaesthesia (RA) focus on patient safety and outcomes. New techniques like ultrasound-guided blocks and advanced technology improve nerve block efficacy and patient care.

Keywords:
Catheterslocal anaestheticsneedlesnerve blockspinal anaesthesiaultrasonography

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Area of Science:

  • Anesthesiology and Pain Management
  • Regional Anesthesia Techniques
  • Medical Technology in Anesthesia

Background:

  • Patient safety, quality of care, and functional outcomes are paramount in regional anaesthesia (RA).
  • Current RA advancements aim to enhance these key priorities.
  • Technological integration is crucial for improving RA practices.

Purpose of the Study:

  • To highlight the evolving landscape of regional anaesthesia.
  • To emphasize the role of advanced technologies and techniques in RA.
  • To underscore the importance of sonoanatomy and microarchitecture understanding for anesthesiologists.

Main Methods:

  • Review of popular clinical interests in RA, including ultrasonography-guided blocks.
  • Discussion of novel techniques such as fascial plane blocks and diaphragm-sparing blocks.
  • Emphasis on injection pressure monitoring and advanced ultrasound/needle technology.

Main Results:

  • Ultrasonography-guided blocks, continuous nerve block techniques, and wound infiltration catheters are of significant clinical interest.
  • Injection pressure monitoring and advanced technology enhance nerve block safety and efficacy.
  • Development of procedure-specific and motor-sparing nerve blocks.

Conclusions:

  • Anesthesiologists equipped with sonoanatomy knowledge and advanced technology can excel in RA.
  • Regional anaesthesia is rapidly evolving, transforming anesthesia practice.
  • The integration of technology and refined techniques is key to future RA success.