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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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Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action01:17

Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action

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Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
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Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

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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...
353
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

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Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

680
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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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

459
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
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[The Stadium analgeticum - Historical Highlights on the Ether Rush].

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[A German-German fate: Heinz Ruppert-A forgotten pioneer of peridural anaesthesia and the last ship's doctor of the PAMIR].

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Intravenous Regional Anesthesia: A Historical Overview and Clinical Review.

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Updated: Jul 22, 2025

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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[The paracervical block: the method and its pioneer].

Michael Goerig1

  • 1, Feldhoopstücken 36-40, 22529, Hamburg, Deutschland. michael.goerig@arcor.de.

Die Anaesthesiologie
|July 21, 2023
PubMed
Summary

The paracervical block (PCB) was a popular pain relief method in childbirth until risks to the fetus emerged. This historical review outlines the procedure

Keywords:
Obstetric anaesthesiaParacervical blockPioneers of obstetric anaesthesiaRegional anaesthesia in obstetricsThe beginnings of local anaesthesia during childbirth

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Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs
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Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs
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Published on: December 7, 2012

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Area of Science:

  • Obstetrics and Gynecology
  • Anesthesiology
  • Medical History

Context:

  • The paracervical block (PCB) was widely used for pain relief during childbirth from the 1950s to the late 1980s.
  • Initially favored for its simplicity and perceived safety, it was performed by obstetricians.
  • Its popularity waned due to identified risks, particularly to the fetus, rendering it largely obsolete.

Purpose:

  • To explore the historical implementation and eventual decline of the paracervical block (PCB) in obstetric pain management.
  • To trace the origins of the PCB procedure to Philipp Gellert, a German physician.
  • To provide biographical details of Philipp Gellert and contextualize his contributions within medical history.

Summary:

  • The paracervical block (PCB) offered pain relief during labor but was later deemed risky for fetuses.
  • Philipp Gellert pioneered this regional anesthesia technique in 1926, combining it with other methods.
  • The paper details the PCB's history and Gellert's life, who was persecuted for his Jewish heritage.

Impact:

  • Highlights the evolution of pain management techniques in obstetrics.
  • Underscores the importance of reassessing safety protocols in medical procedures.
  • Preserves the history of an anesthetic technique and the legacy of its originator.