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Related Concept Videos

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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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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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.
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Related Experiment Video

Updated: Jun 6, 2025

An Ultrasonic Tool for Nerve Conduction Block in Diabetic Rat Models
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Nerve Block Extends Nerve Function Recovery in Patients with Diabetic Foot Ulcers.

Qiufeng Wei1, Heng Rong1, Guangying Zhang1

  • 1Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530021, People's Republic of China.

Journal of Pain Research
|November 27, 2024
PubMed
Summary

Patients with diabetic foot have higher nerve stimulation thresholds for femoral and sciatic nerve blocks. This leads to a longer duration of nerve block and delayed recovery, with some instances of nerve injury observed.

Keywords:
diabetic footminimal stimulation thresholdnerve blocksnerve damageultrasound

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Area of Science:

  • Anesthesiology
  • Diabetology
  • Neurology

Background:

  • Peripheral neuropathy in diabetes mellitus (DM) is associated with elevated nerve stimulation thresholds.
  • Specific nerve stimulation thresholds and block recovery in diabetic foot patients are not well-defined.

Purpose of the Study:

  • To determine the minimum stimulation thresholds of the femoral and sciatic nerves in diabetic foot patients.
  • To assess the duration of nerve block and nerve function recovery in this population.

Main Methods:

  • Prospective study of 83 diabetic foot patients and 48 controls (age 50-80) undergoing distal lower limb surgery.
  • Ultrasound-guided femoral and popliteal sciatic nerve blocks using ropivacaine were performed.
  • Minimum electrical current for motor response in femoral and sciatic nerves was measured.

Main Results:

  • Diabetic foot patients showed significantly higher stimulation thresholds for femoral and sciatic nerves (P < 0.01).
  • Femoral and sciatic sensory and motor blocks were substantially longer in duration for diabetic foot patients (P < 0.01).
  • Nerve injury occurred in 4.8% of diabetic foot patients.

Conclusions:

  • Diabetic foot patients require higher stimulus to elicit nerve response.
  • Ropivacaine nerve blocks exhibit prolonged duration and delayed recovery in diabetic foot patients.
  • Higher incidence of nerve injury noted in diabetic foot patients.