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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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Depolarizing Blockers: Pharmocokinetics01:19

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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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The intertransverse process block single- or multiple-injection? A study protocol.

Amanda de la Fuente Birkebaek1, Katrine Tanggaard1, Sophie Bojesen2

  • 1Department of Anaesthesiology and Intensive Care Medicine, Zealand University Hospital, Roskilde, Denmark.

Acta Anaesthesiologica Scandinavica
|April 29, 2023
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Summary
This summary is machine-generated.

This study compares single-injection versus multiple-injection intertransverse process (ITP) blocks for thoracic paravertebral anesthesia. Results clarify sensory loss extent and potential thermography use in evaluating ITP block efficacy.

Keywords:
intertransverse process blockperipheral nerve blocksingle- versus multiple-injection

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Area of Science:

  • Anesthesiology
  • Pain Management
  • Regional Anesthesia

Background:

  • Intertransverse process (ITP) blocks are posterior thoracic paravertebral space blocks.
  • ITP blocks are considered a proxy for thoracic paravertebral blocks, potentially offering similar analgesia.
  • Evidence on dermatome anesthesia and sensory loss from ITP blocks is limited.

Purpose of the Study:

  • To compare the efficacy of single-injection versus multiple-injection ITP blocks.
  • To determine the number of anaesthetised thoracic dermatomes for each block type.
  • To explore the clinical utility of thermography in assessing nerve block effectiveness.

Main Methods:

  • A randomized, double-blinded, crossover trial involving 12 healthy male volunteers.
  • Participants received either a single-injection or multiple-injection ITP block with ropivacaine, followed by sham blocks or the alternative injection on separate days.
  • Sensory testing (pinprick, temperature) and anterior truncal thermography were performed post-block; blood pressure was also monitored.

Main Results:

  • The study aims to quantify the extent of cutaneous sensory loss following ITP blocks.
  • It will compare the number of anaesthetised thoracic dermatomes between single and multiple injection techniques.
  • Changes in skin temperature via thermography will be analyzed to assess block efficacy.

Conclusions:

  • This research will significantly enhance understanding of the sensory deficits associated with ITP blocks.
  • Findings may validate thermography as a reliable tool for measuring the effectiveness of nerve blocks.
  • The study contributes to the evidence base for thoracic paravertebral analgesia techniques.