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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

639
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...
639
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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Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

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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...
488
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

433
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...
433
Stages of General Anesthesia01:22

Stages of General Anesthesia

458
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
458
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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Spinal anesthesia efficiency in thoracolumbar stabilizations.

Mehmet Huseyin Akgul1, Mehmet Yigit Akgun2

  • 1Department of Neurosurgery, Yuksek Ihtisas Hospital, Kirikkale, Turkey.

Ideggyogyaszati Szemle
|December 5, 2023
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Summary

Spinal anesthesia (SA) is effective for lumbar and thoracolumbar surgery, showing significant improvements in pain and quality of life. Careful patient selection is key for optimal outcomes in spinal stabilization procedures.

Keywords:
anesthesialumbarspinalstabilizationthoracolumbar

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Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Spinal Surgery

Background:

  • Spinal surgery, including lumbar procedures like stabilization and discectomy, is a key neurosurgical practice.
  • Lumbar and lower thoracic spinal surgery can be safely performed under spinal anesthesia (SA).
  • Limited studies exist on SA's safety and efficacy in long-segment spinal stabilization surgery.

Purpose of the Study:

  • To evaluate the safety and efficacy of spinal anesthesia (SA) versus general anesthesia (GA) in patients undergoing lumbar and thoracolumbar spinal instrumentation.
  • To compare patient outcomes, including pain and quality of life, between SA and GA groups.

Main Methods:

  • A comparative study included patients undergoing lumbar/thoracolumbar spinal instrumentation with either SA or GA.
  • Demographic data, American Society of Anesthesiologists (ASA) physical status, Visual Analog Scale (VAS), and quality of life scores were recorded.
  • Patients were followed up to assess outcomes post-operation.

Main Results:

  • The study included 572 patients receiving SA and 598 receiving GA for short/long segment stabilization.
  • Both groups showed statistically significant improvements in VAS and quality of life scores (p<0.05).
  • Mobilization times were 16-24 hours for SA and 24-36 hours for GA.

Conclusions:

  • Spinal anesthesia is a highly effective method for lumbar and thoracolumbar spinal surgery.
  • Careful patient selection and the use of SA can enhance surgical comfort and patient outcomes.
  • SA demonstrates efficacy in improving pain and quality of life in spinal surgery patients.