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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

686
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

491
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...
491
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

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

Local Anesthetics: Clinical Application as Epidural Anesthesia

463
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...
463
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

817
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...
817
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

691
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...
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[Interventional Pain Management - Are Targeted Infiltrations Efficient?]

Jan Triebel1

  • 1Rehabilitation, Rheumatologie, Interventionelle Schmerztherapie, Spital Schwyz, Schweiz.

Therapeutische Umschau. Revue Therapeutique
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Summary

Targeted infiltrations in interventional pain management provide a low-risk option to precisely target pain sources. This can effectively relieve pain and improve function, potentially avoiding the need for spine surgery.

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Area of Science:

  • Pain Medicine
  • Musculoskeletal Disorders
  • Neurosurgery

Context:

  • Interventional pain management offers a minimally invasive approach.
  • Targeted infiltrations aim to precisely address the source of pain.
  • This method is non-structurally altering.

Purpose:

  • To evaluate the efficiency of targeted infiltrations in interventional pain management.
  • To determine if targeted infiltrations can relieve pain and improve function.
  • To assess the potential of these interventions to avoid spine surgery.

Summary:

  • Interventional pain management utilizes targeted infiltrations as a low-risk, minimally invasive option.
  • These procedures can precisely identify and treat nociceptive structures.
  • Successful treatment can lead to significant pain relief and functional improvement.

Impact:

  • Provides a viable alternative to traditional pain management strategies.
  • Offers a method to potentially avoid invasive spine surgery.
  • Improves patient outcomes through targeted pain relief and enhanced function.