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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

339
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...
339
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

568
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...
568
General Anesthesia: Overview01:24

General Anesthesia: Overview

183
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...
183
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

919
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...
919
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

404
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...
404
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

449
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...
449

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Current Strategies in Regional Anesthesia for Shoulder Surgery.

Linda L Zhang1, Sanjay K Sinha, Anand M Murthi

  • 1From the Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD (Zhang and Murthi), and the Department of Anesthesiology, St. Francis Hospital and Medical Center, Hartford, CT (Sinha).

The Journal of the American Academy of Orthopaedic Surgeons
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PubMed
Summary

Optimal pain management after outpatient shoulder surgery involves regional anesthesia, specifically brachial plexus blocks, combined with multimodal medications. This approach enhances pain control and reduces opioid side effects for better patient outcomes.

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Area of Science:

  • Anesthesiology
  • Orthopedic Surgery

Background:

  • Outpatient shoulder surgery requires effective pain management to minimize adverse effects.
  • Traditional opioids and nonopioids offer limited pain relief and significant side effects.

Purpose of the Study:

  • To review current anesthetic and analgesic strategies for shoulder surgery.
  • To highlight the benefits of regional anesthesia and multimodal approaches.

Main Methods:

  • Review of advances in ultrasonography-guided regional anesthesia.
  • Focus on interscalene brachial plexus nerve blocks and phrenic nerve-sparing techniques.

Main Results:

  • Regional anesthesia, particularly brachial plexus blocks, offers precise and reliable pain control.
  • Novel techniques minimize risks like diaphragmatic paresis and dyspnea.

Conclusions:

  • Combining brachial plexus blocks with multimodal medications is the preferred strategy.
  • This approach provides comprehensive analgesia, targets multiple pain pathways, and reduces opioid use.