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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

475
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...
475
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

684
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...
684
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
Regional Terms01:12

Regional Terms

9.7K
Regional terms describe anatomy by dividing the body parts into different regions that contain structures involved in contributing similar functions. Using these terms helps increase the accurate description and identification of the particular region of interest or region affected by the disease.
Primarily, the human body has two major regions, the axial and appendicular regions. The axial region comprises regions from the head to the abdomen and makes up the central body axis. In contrast,...
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Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

806
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...
806
General Anesthesia: Overview01:24

General Anesthesia: Overview

245
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...
245

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Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
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Regional Anesthesia in Upper-Limb Surgery.

Lachlan McLennan1, Morgan Haines2, David Graham3

  • 1From the Royal North Shore Hospital.

Annals of Plastic Surgery
|July 14, 2023
PubMed
Summary
This summary is machine-generated.

Local and regional anesthesia offers advantages over general anesthesia for upper-limb surgery. Recent advances, including ultrasound guidance, improve outcomes and enable procedures in diverse settings.

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Area of Science:

  • Anesthesiology and surgical procedures.
  • Regional anesthesia techniques.

Background:

  • Local and regional anesthesia provide clinical and institutional benefits compared to general anesthesia.
  • Understanding the principles, evolution, and trends in modern anesthetic techniques is crucial for practitioners.
  • The integration of local and regional anesthesia into clinical practice is increasing.

Approach:

  • A comprehensive literature review was conducted using Medline, PubMed, and EMBASE.
  • The review focused on identifying recent developments, ongoing trends, and historical milestones.
  • The scope was specifically limited to upper-limb regional anesthesia.

Key Points:

  • Regional anesthesia has evolved significantly over the past century, enhancing safety and outcomes in upper-limb surgery.
  • Ultrasound-guided techniques and advancements in local anesthetic pharmacology have further improved regional anesthesia.
  • Wide-awake local anesthesia without a tourniquet facilitates outpatient and low-resource surgical procedures.

Conclusions:

  • This review details the historical progression and current applications of upper-limb local and regional anesthesia.
  • Contemporary uses are highlighted, with a specific focus on their role during the COVID-19 pandemic.
  • The review underscores the continued relevance and advancements in regional anesthesia for upper-limb procedures.