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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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Blood and Nerve Supply to the Bones01:29

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Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
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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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Peripheral Nerve Blocks for Hip Fractures.

Iyabo O Muse1, Brittany Deiling1, Leon Grinman1

  • 1Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, USA.

Journal of Clinical Medicine
|June 27, 2024
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Summary
This summary is machine-generated.

Hip fractures are rising in older adults, increasing morbidity and mortality. This review explores peripheral nerve blocks for effective pain management, crucial for recovery and early mobilization in hip fracture patients.

Keywords:
fascia iliaca blocklateral femoral cutaneous nervepericapsular nerve group (PENG) block

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Area of Science:

  • Geriatric Medicine
  • Orthopedic Surgery
  • Pain Management

Background:

  • Hip fractures are a growing concern in the aging population, leading to significant morbidity and mortality.
  • Early surgical intervention and effective pain management are vital for improving outcomes in geriatric hip fracture patients.
  • Multimodal pain therapy, including regional anesthesia, is standard for optimizing recovery and mobilization.

Purpose of the Study:

  • To review the anatomical innervation of the hip joint.
  • To summarize established and novel peripheral nerve blocks for hip fracture pain relief.
  • To evaluate the literature supporting the efficacy of these nerve blocks.

Main Methods:

  • Anatomical review of hip joint innervation.
  • Literature search for peripheral nerve blocks used in hip fracture management.
  • Analysis of evidence for the efficacy of various nerve blocks.

Main Results:

  • Detailed description of hip joint nerve supply.
  • Summary of commonly used peripheral nerve blocks and their effectiveness.
  • Introduction of a new nerve block targeting the posterior hip capsule.

Conclusions:

  • Peripheral nerve blocks offer effective pain management for hip fractures.
  • Optimizing pain control with nerve blocks facilitates early mobilization and functional recovery.
  • Emerging techniques, like posterior hip capsule blockade, show promise for enhanced analgesia.