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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

427
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...
427
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

381
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...
381
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

601
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...
601
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

999
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...
999
General Anesthesia: Overview01:24

General Anesthesia: Overview

199
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...
199
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

752
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...
752

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Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
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Pipeline embolization device placement under local versus general anesthesia: a propensity score-matched study.

Longhui Zhang1,2, Chao Wang3,4, Xuefang Wu5

  • 1Departments of1Interventional Neuroradiology and.

Journal of Neurosurgery
|August 10, 2024
PubMed
Summary

Pipeline embolization device (PED) placement for intracranial aneurysms using local anesthesia (LA) is as safe and effective as general anesthesia (GA). LA significantly reduces procedure time and hospital costs without compromising patient outcomes.

Keywords:
Pipeline embolization deviceendovascular neurosurgeryhospital costintracranial aneurysmlocal anesthesiaturnover timevascular disorders

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Area of Science:

  • Neurosurgery
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Pipeline Embolization Device (PED) placement is a common treatment for intracranial aneurysms.
  • General anesthesia (GA) is typically used but carries risks and increases costs.
  • Local anesthesia (LA) offers a potential alternative to reduce procedural burden.

Purpose of the Study:

  • To compare clinical outcomes and hospital costs of PED placement for intracranial aneurysms under LA versus GA.
  • To evaluate the safety and efficacy of LA for PED procedures.
  • To determine the impact of anesthesia type on procedural efficiency and healthcare expenditure.

Main Methods:

  • Retrospective analysis of 216 patients with 223 intracranial aneurysms treated with PED.
  • Patients were grouped by anesthesia type: local anesthesia (LA) or general anesthesia (GA).
  • Propensity score matching (PSM) was employed to balance patient characteristics and minimize bias.

Main Results:

  • 84 patients (88 aneurysms) received LA, and 132 patients (135 aneurysms) received GA.
  • Similar complication rates and 6-month modified Rankin Scale scores were observed between LA and GA groups.
  • LA group showed significantly shorter procedural times and lower hospital costs compared to the GA group, both before and after PSM.

Conclusions:

  • PED placement under LA achieves comparable clinical outcomes to GA.
  • Utilizing LA for PED placement significantly reduces procedural duration.
  • Local anesthesia offers a cost-effective alternative for PED procedures, improving resource utilization.