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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

400
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...
400
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

561
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...
561
Analgesia and Pain Management01:25

Analgesia and Pain Management

403
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
403
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

738
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...
738
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

332
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...
332
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

705
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
705

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Updated: May 16, 2025

Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
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Using Multi-Site Research Results to Impact Local Pediatric Pain Evidence-Based Practice: Innovations and Outcomes.

Nicole L Bohr1, Cynthia M LaFond1,2, Mary Cazzell3

  • 1Department of Nursing Research and Evidence-Based Practice at UChicago Medicine, Chicago, Illinois, USA.

Worldviews on Evidence-Based Nursing
|April 1, 2025
PubMed
Summary
This summary is machine-generated.

Sharing local results from multi-site pediatric pain studies benefits participating organizations. This led to practice changes, new collaborations, and quality improvement initiatives, demonstrating the value of disseminating research findings.

Keywords:
evidence‐based practiceinformation disseminationmagnetmulti‐site researchnursing practice improvementresults sharing

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Area of Science:

  • Clinical Research
  • Health Services Research
  • Pediatric Pain Management

Background:

  • Disseminating research findings offers value beyond primary study aims.
  • Sharing local results in multi-site research is not standard but can benefit participating organizations.
  • There is a need to evaluate the impact of results sharing in multi-site research.

Purpose of the Study:

  • Assess benefits of organizational participation in a multi-site pediatric pain study when results were shared.
  • Identify how sites applied local results and the outcomes of participation.
  • Evaluate subsequent improvement efforts and scholarship.

Main Methods:

  • A 12-hospital multi-site study collected data.
  • Site research teams shared experiences and lessons learned.
  • Four years later, sites were surveyed about initiatives undertaken due to the primary study.

Main Results:

  • Ten of 12 sites reported unanticipated benefits, including identifying documentation gaps and new improvement opportunities.
  • Seven sites responded to a 4-year follow-up survey.
  • Most sites (85.7%) used data for practice changes in documentation, assessment, policy, and treatments.

Conclusions:

  • Providing local data in multi-site research yields long-term organizational benefits like collaborations and quality improvement.
  • Further exploration of investigator-practice setting collaborations is needed for pediatric pain management.
  • Sharing results fosters new research and quality improvement efforts.