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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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...

Local Anesthetics: Clinical Application as Spinal Anesthesia

Local Anesthetics: Clinical Application as Spinal Anesthesia

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...

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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...

Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

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...

Local Anesthetics: Pharmacokinetics

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...

Local Anesthetics: Common Agents and Their Applications

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...

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Regional Anesthesia in the Elite Athlete.

Patrick Meyer¹, Kristopher Schroeder¹

¹Department of Anesthesiology, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.

Anesthesiology Clinics

|May 5, 2024

Summary

Regional anesthesia offers benefits for elite athletes with musculoskeletal injuries, but concerns about functional recovery exist. This review examines the safety, strategies, and consent for these procedures in athletes.

Keywords:

Analgesia Athlete Consent Nerve block Nerve injury Regional anesthesia

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Area of Science:

Sports Medicine
Anesthesiology
Orthopedics

Background:

Elite athletes face high risks of musculoskeletal injuries, impacting careers.
Regional anesthesia is common for injuries but raises concerns in athletes.
Athletes may have less tolerance for risks impacting functional recovery.

Purpose of the Study:

Review data on regional anesthesia risks for elite athletes.
Discuss strategies to enhance safety of regional anesthesia in athletes.
Explore informed consent for elite athletes undergoing these procedures.

Main Methods:

Literature review of studies on regional anesthesia and athletic recovery.
Analysis of anesthetic techniques and outcomes in elite athletes.
Examination of ethical considerations and consent processes.

Main Results:

Data on adverse effects of regional anesthesia on athletic function is limited.
Regional anesthesia can be safe and effective with appropriate planning.
Informed consent must address specific athletic concerns.

Conclusions:

Regional anesthesia can be safely utilized in elite athletes with careful management.
Strategies exist to mitigate risks and optimize functional recovery.
Tailored informed consent is crucial for this population.