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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: 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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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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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...
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Hand hygiene01:23

Hand hygiene

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Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
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Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

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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...
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Related Experiment Video

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Author Spotlight: Minimally Invasive Relief for Occipital Neuralgia at the Nuchal Line
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SKIN ANTISEPSIS PRACTICES FOR CENTRAL NEURAXIAL BLOCKADE.

Abdullah Nisar1, Azhar Rehman1, Ali Sarfraz Siddiqui1

  • 1Department of Anaesthesiology, Aga Khan University Hospital, Karachi-Pakistan.

Journal of Ayub Medical College, Abbottabad : JAMC
|November 25, 2024
PubMed
Summary

Povidone-iodine is the most common skin antiseptic before central neuraxial blockade, despite chlorhexidine being recommended. This practice is influenced by personal preference, cost, and availability, not international standards.

Keywords:
Skin antisepsis; Neuraxial anaesthesia; Regional anaesthesia; Patient safety

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Area of Science:

  • Anesthesiology
  • Infection Control
  • Public Health

Background:

  • Skin antisepsis is critical before central neuraxial blockade to prevent infections.
  • Common antiseptic agents include povidone-iodine, alcohol, and chlorhexidine.
  • This study evaluated current skin antisepsis practices and adherence to international standards in Karachi, Pakistan.

Purpose of the Study:

  • To assess current skin antisepsis practices before central neuraxial blockade.
  • To evaluate anaesthesiologists' compliance with international standards in Karachi teaching hospitals.

Main Methods:

  • A cross-sectional study was conducted among anaesthesia faculty in Karachi teaching hospitals (March-May 2022).
  • Data collected included antiseptic solution used, application method, and reasons for choice.
  • Practices were assessed against recommendations, with stratification analysis performed.

Main Results:

  • Povidone-iodine was the most frequently used antiseptic solution.
  • Sponge/swab with Gallipot was the predominant application method (94.3%).
  • Reasons for choice included personal preference, cost-effectiveness, and availability; 50% recommended chlorhexidine 2%, but it wasn't widely used.

Conclusions:

  • Povidone-iodine remains the most common agent for skin antisepsis before central neuraxial blockade.
  • The recommended antiseptic, chlorhexidine, is underutilized due to factors like personal preference, cost, and availability.