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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

350
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...
350
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

570
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...
570
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

930
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...
930
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

460
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
460
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

407
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...
407

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Related Experiment Video

Updated: May 27, 2025

In Vivo Intracellular Recording of Type-Identified Rat Spinal Motoneurons During Trans-Spinal Direct Current Stimulation
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Vastus lateralis nerve block for knee hardware removal.

Jibran Ikram1, Aariya Srinivasan1, Cassandra L Williams2

  • 1Department of Anesthesiology, Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA.

Saudi Journal of Anaesthesia
|February 17, 2025
PubMed
Summary

Peripheral nerve blocks, including the vastus lateralis block, effectively managed severe knee surgery pain, reducing opioid needs. This opioid-sparing strategy enhances recovery and supports early patient mobilization.

Keywords:
Opioid sparingpain managementperipheral nerve blocksvastus lateralis block

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Area of Science:

  • Orthopedics
  • Anesthesiology
  • Pain Management

Background:

  • Effective pain management after knee surgery is essential for patient recovery and reducing opioid dependence.
  • Complications like hardware prominence can lead to persistent pain, complicating post-operative care.

Observation:

  • A patient experienced persistent medial knee pain after open reduction and internal fixation (ORIF) for a comminuted patellar fracture, attributed to hardware prominence.
  • Initial opioid analgesia under general anesthesia was insufficient for severe postoperative pain.

Findings:

  • Rescue analgesia with peripheral nerve blocks, specifically adductor canal, anterior femoral cutaneous, and vastus lateralis blocks, provided significant pain relief.
  • The vastus lateralis block demonstrated particular efficacy in managing severe postoperative pain, enabling opioid-sparing effects.

Implications:

  • Peripheral nerve blocks offer a viable opioid-sparing alternative for managing severe postoperative knee pain.
  • Wider adoption of regional anesthesia techniques can improve perioperative outcomes and facilitate early mobilization in orthopedic patients.
  • This approach addresses challenges posed by opioid dependence while enhancing patient rehabilitation.