Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

329
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...
329
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

376
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
376
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

895
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...
895
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

555
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...
555
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

399
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...
399
General Anesthesia: Overview01:24

General Anesthesia: Overview

154
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...
154

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

LLM-guided contrastive evidence mining for explainable cyber threat intelligence classification.

iScience·2026
Same author

The role of community capacity building (CCB) in promoting local development: Analyzing leadership in the Hyderabad cantonment community.

PloS one·2026
Same author

The predictive nature of diagnostic nerve blocks for lower extremity spasticity management with botulinum toxin and neurotomy: A systematic review.

PM & R : the journal of injury, function, and rehabilitation·2026
Same author

Commentary on "The Classification of Nerve Injury Revisited: Sundland 0-VI": Toward a Roadmap for Surgical Decision Making in Nerve Injury.

Plastic surgery (Oakville, Ont.)·2026
Same author

Boosting underwater image quality: a deep learning approach to denoising and enhancement.

Scientific reports·2026
Same author

Systematic Review of Leiomyomas of the Upper Extremity: Evaluating the Role of Ultrasound in Preoperative Diagnosis.

Hand (New York, N.Y.)·2026

Related Experiment Video

Updated: May 12, 2025

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
08:49

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

Published on: October 16, 2013

13.6K

A Practical Guide to Local Anesthetic Options for Wide-awake Hand Surgery (WALANT): A Laboratory-based Experimental

Ahmad AlShammari1, Julia M Harrison1, Bradley Greene1

  • 1From Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Plastic and Reconstructive Surgery. Global Open
|May 7, 2025
PubMed
Summary

Supply chain issues limit local anesthetic options for wide-awake local anesthesia no tourniquet (WALANT) hand surgery. This study provides guidance on buffering local anesthetics with sodium bicarbonate to achieve optimal pH for comfortable injections.

More Related Videos

Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics
08:16

Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics

Published on: July 23, 2020

2.1K
Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
05:43

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

16.5K

Related Experiment Videos

Last Updated: May 12, 2025

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
08:49

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

Published on: October 16, 2013

13.6K
Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics
08:16

Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics

Published on: July 23, 2020

2.1K
Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
05:43

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

16.5K

Area of Science:

  • Anesthesiology
  • Hand Surgery
  • Pharmacology

Background:

  • Ongoing supply chain disruptions affect the availability of local anesthetics for hand surgery.
  • Wide-awake local anesthesia no tourniquet (WALANT) procedures require specific local anesthetic preparations, often involving epinephrine and sodium bicarbonate.
  • Optimizing the pH of local anesthetics is crucial for reducing injection pain and ensuring patient comfort during WALANT procedures.

Purpose of the Study:

  • To determine the optimal buffering capacity of sodium bicarbonate (NaHCO₃) for various local anesthetics used in WALANT hand surgery.
  • To provide practical guidance for surgeons on preparing local anesthetic solutions with adjusted pH for improved patient experience.
  • To identify which local anesthetics can be safely buffered without precipitation.

Main Methods:

  • Tested pH levels of commercially available local anesthetics including lidocaine, bupivacaine, mepivacaine, and ropivacaine.
  • Systematically added sodium bicarbonate (NaHCO₃) in 0.1 mL increments to buffered samples until a target physiological pH was reached or precipitate formed.
  • Evaluated the compatibility of epinephrine with different local anesthetics and buffering agents.

Main Results:

  • 1.0 mL of 8.4% sodium bicarbonate per 10 mL of 1% lidocaine with epinephrine yielded a pH of 7.3.
  • Bupivacaine precipitated with >0.2 mL NaHCO₃ per 10 mL; ropivacaine precipitated with all tested volumes of NaHCO₃.
  • Mepivacaine could be buffered with 0.3 mL NaHCO₃ per 10 mL without precipitation, achieving physiological pH.

Conclusions:

  • Specific volumes of sodium bicarbonate can be used to buffer lidocaine and mepivacaine to achieve optimal pH for WALANT procedures.
  • Bupivacaine and ropivacaine are not suitable for buffering with sodium bicarbonate due to precipitation issues.
  • This research offers essential guidance for surgeons to prepare safe and comfortable local anesthetic solutions amidst supply chain challenges.