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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

646
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...
646
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

438
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...
438
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

435
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...
435
General Anesthesia: Overview01:24

General Anesthesia: Overview

225
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...
225
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

492
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Related Experiment Video

Updated: Jul 11, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
03:14

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Spinal anesthesia in elective lumbar spinal surgery.

Nicholas S Hernandez1, Benayas Begashaw2, Ron I Riesenburger1

  • 1Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA.

Anesthesia and Pain Medicine
|November 3, 2023
PubMed
Summary

Spinal anesthesia (SA) offers a safe alternative for lumbar surgery. This guide provides a standardized workflow to increase its adoption for awake spine surgery.

Keywords:
Awake spine surgeryIntrathecal bupivacaineNeuroanesthesiaSpinal anesthesiaSpine surgery

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Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Spinal Surgery

Background:

  • Spinal anesthesia (SA) is a safe and effective alternative to general anesthesia for elective lumbar surgery.
  • Limited familiarity with SA management has hindered the adoption of awake spine surgery.
  • A standardized workflow for SA in lumbar surgery is currently lacking.

Purpose of the Study:

  • To review current literature on SA for lumbar surgery.
  • To share institutional experience with SA in lumbar surgery.
  • To provide a cohesive outline for implementing SA in lumbar surgery.

Main Methods:

  • Literature review on SA in lumbar surgery.
  • Analysis of institutional experience with SA.
  • Development of a standardized SA workflow for anesthesiologists.

Main Results:

  • SA is a viable option for elective lumbar procedures.
  • Key considerations include patient selection, SA techniques, sedation, and technical aspects.
  • A structured approach can improve SA implementation.

Conclusions:

  • Standardizing SA workflows can enhance its accessibility and adoption for eligible patients.
  • This approach aims to reduce the learning curve for anesthesiologists.
  • Increased use of SA can facilitate awake spine surgery.