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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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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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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: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
817
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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Updated: Jun 30, 2025

Author Spotlight: Minimally Invasive Relief for Occipital Neuralgia at the Nuchal Line
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Cervical Nerve Root Block Using a Curved Blunt Needle and Posterior Approach.

Carl Noe1, Michael van Hal2, Standiford Helm Ii3

  • 1Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX.

Pain Physician
|March 20, 2024
PubMed
Summary
This summary is machine-generated.

A new posterior approach for cervical selective nerve root blocks using a curved blunt needle offers a safer alternative. This technique effectively identifies pain-causing nerves with a high immediate analgesic effect and a prolonged response rate of 50%.

Keywords:
cervical disk herniationcervical foraminal stenosiscervical radicular paincervical radiculopathycervical selective nerve root blockcervical stenosiscervical transforaminal steroid injectionCervical radiculitis

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Area of Science:

  • Pain Management
  • Neurology
  • Interventional Pain Procedures

Background:

  • Cervical transforaminal epidural steroid injections are declining due to severe complication risks.
  • Cervical nerve root blocks are valuable for surgical planning in cervical radicular pain.

Purpose of the Study:

  • To develop a safer method for cervical selective nerve root blocks.
  • To eliminate the risk of catastrophic complications associated with these procedures.

Main Methods:

  • Retrospective case review of 50 consecutive patients at an academic multidisciplinary spine center.
  • Utilized a posterior approach with a curved blunt needle for cervical selective nerve root blocks.
  • Assessed outcomes using immediate pain scores, follow-up results, quantitative pain severity, and qualitative responses.

Main Results:

  • The technique demonstrated a high immediate analgesic effect, suitable for diagnostic purposes.
  • A prolonged response rate of approximately 50% was observed, comparable to existing methods.
  • The study did not determine the prognostic value of this technique for surgical outcomes.

Conclusions:

  • Cervical selective nerve root blocks with a posterior approach and curved blunt needle are effective for identifying symptomatic nerves.
  • This method minimizes risks of arterial injection and spinal cord impingement, potentially offering greater safety than transforaminal approaches.