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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

380
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...
380
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

987
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...
987
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

592
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...
592
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

315
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
315
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

795
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...
795
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

1.5K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
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Related Experiment Video

Updated: Jun 13, 2025

In Vivo Intracellular Recording of Type-Identified Rat Spinal Motoneurons During Trans-Spinal Direct Current Stimulation
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SIMBA-A Single-Puncture Approach to Lower Limb Block.

Mukesh Kumar Prasad1, Payal Jain

  • 1From the Department of Anaesthesia and Pain, Teerthankar Mahaveer Medical College, Moradabad, Uttar Pradesh, India.

A&A Practice
|September 13, 2024
PubMed
Summary
This summary is machine-generated.

Single-Insertion Multiple Nerve Block Anesthesia (SIMBA) offers a safe anesthetic option for elderly femur fracture patients. This technique successfully managed pain in cardiac patients without significant hemodynamic changes.

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Area of Science:

  • Anesthesiology
  • Orthopedic Surgery
  • Geriatric Medicine

Background:

  • Peripheral nerve blocks are effective for femur fracture anesthesia, especially in elderly patients with comorbidities.
  • Anesthetic management in geriatric patients with significant comorbidities presents unique challenges.
  • Femur fractures in the elderly often require careful consideration of anesthetic risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of Single-Insertion Multiple Nerve Block Anesthesia (SIMBA) for femur fractures in elderly patients.
  • To assess hemodynamic stability and postoperative analgesia using the SIMBA technique in a geriatric population.
  • To determine if SIMBA is a viable alternative anesthetic for high-risk elderly patients with femur fractures.

Main Methods:

  • SIMBA involves a single needle insertion to block the femoral, obturator, lateral femoral cutaneous, and sciatic nerves.
  • The technique was applied to 11 geriatric patients with cardiac compromise and femur shaft fractures.
  • Intraoperative hemodynamic parameters and postoperative pain scores were monitored.

Main Results:

  • The SIMBA technique was successfully performed in all 11 patients.
  • No significant hemodynamic changes were observed during surgery.
  • Patients experienced good postoperative analgesia.

Conclusions:

  • SIMBA is a safe and reliable anesthetic alternative for femur fractures in elderly patients with comorbidities.
  • The technique provides effective pain management with minimal hemodynamic impact in this vulnerable population.
  • SIMBA demonstrates potential for improved anesthetic outcomes in geriatric orthopedic surgery.