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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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

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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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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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Updated: Jul 15, 2025

Operational and Intervention Effects of Targeted Tuina in Lumbar Intervertebral Disc Degeneration Model Rabbits
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Racial and Ethnic Disparities in Inpatient Interventional Pain Management for Lumbar Radiculopathy.

Robert Louis1, David W Boorman2, Ashley Rogers2

  • 1Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital Boston, MA; Emory University School of Medicine, Atlanta, GA.

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Summary

Racial and ethnic disparities exist in lumbar radiculopathy treatment. African Americans and Hispanics received more conservative therapies like physical therapy and epidural steroid injections than whites.

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Area of Science:

  • Pain Management
  • Interventional Pain Procedures
  • Health Disparities

Background:

  • Chronic pain affects many adults, with spine-related pain and lumbar radiculopathy being common concerns.
  • While pharmacologic pain management disparities are known, interventional procedure disparities require further study.
  • Keywords: Chronic pain, pain management, back pain, lumbar radiculopathy, racial disparities, gender disparities.

Purpose of the Study:

  • To investigate utilization rates of physical therapy, epidural steroid injections, surgery, and spinal cord stimulation in hospitalized lumbar radiculopathy patients.
  • To analyze these utilization rates across different races, ethnicities, and genders.

Main Methods:

  • Retrospective cross-sectional study using the National Inpatient Sample (2016-2019) of 252,790 patients with lumbar radiculopathy.
  • Independent variables included race, ethnicity, age, gender, insurance, geography, year, and disease severity.
  • Logistic regression analysis adjusted for covariates to compare treatment utilization (physical therapy, epidural steroid injection, spinal cord stimulator, surgery).

Main Results:

  • African Americans and Hispanics received more epidural steroid injections and physical therapy compared to whites, relative to surgery.
  • African Americans received spinal cord stimulation less often than whites, relative to surgery.
  • Women received epidural steroid injections more frequently than men, relative to surgery.

Conclusions:

  • Observed disparities in lumbar radiculopathy treatment utilization across race, ethnicity, and gender after adjusting for independent variables.
  • African Americans showed higher conservative therapy use despite increased disease severity; Hispanics and women also showed increased conservative therapy use.
  • Further investigation in outpatient settings is crucial to fully understand and address these treatment disparities.