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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

608
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...
608
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

823
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...
823
General Anesthesia: Overview01:24

General Anesthesia: Overview

308
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...
308
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

1.3K
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...
1.3K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

510
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...
510
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

568
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...
568

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Wide-awake local anesthesia no tourniquet (WALANT) versus brachial plexus block for upper extremity surgery: a systematic review and meta-analysis.

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Pharmacokinetics of local anesthetics following transversus abdominis plane block in the pediatric population.

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Effects of deep parasternal intercostal plane block on opioid consumption and pain after cardiac surgery: a meta-analysis of randomized controlled trials with meta-regression and trial sequential analysis.

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Related Experiment Video

Updated: Sep 20, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

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Regional anesthesia in bariatric surgery.

Alessandro De Cassai1,2, Serkan Tulgar3, Michele Carron1,2

  • 1Department of Medicine (DIMED), University of Padua, Padua, Italy.

Current Opinion in Anaesthesiology
|May 23, 2025
PubMed
Summary
This summary is machine-generated.

Regional anesthesia (RA) techniques like TAP, QL, and ESP blocks can significantly reduce pain and opioid use in bariatric surgery patients. Further research is needed to optimize these methods for improved recovery.

Keywords:
bariatric surgerymultimodal analgesiaobesityopioid reductionregional anesthesia

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Area of Science:

  • Anesthesiology
  • Bariatric Surgery
  • Pain Management

Background:

  • Obesity poses significant perioperative challenges, especially in bariatric surgery.
  • Optimizing pain management while minimizing opioid use is critical for this high-risk population.
  • Regional anesthesia (RA) techniques offer potential benefits for perioperative outcomes.

Purpose of the Study:

  • To review current evidence on RA techniques for pain management in bariatric surgery.
  • To evaluate the efficacy of various RA methods in reducing postoperative pain and opioid consumption.
  • To highlight the importance of RA in multimodal analgesia for obese patients.

Main Methods:

  • Review of current evidence supporting RA techniques.
  • Analysis of specific RA methods including Transversus Abdominis Plane (TAP) block, Quadratus Lumborum (QL) block, Erector Spinae Plane (ESP) block, and intraperitoneal instillation.
  • Consideration of anatomical challenges in obese patients and the role of ultrasound guidance.

Main Results:

  • RA techniques like TAP, QL, and ESP blocks, along with intraperitoneal local anesthetics, reduce postoperative pain and opioid consumption.
  • QL block provides longer-lasting pain relief; intraperitoneal administration aids respiratory recovery.
  • Port-site infiltration is a simple, effective alternative; ultrasound guidance is crucial for obese patients.

Conclusions:

  • Regional anesthesia is integral to multimodal analgesia in bariatric surgery, reducing opioid complications and improving recovery.
  • Further high-quality randomized controlled trials are necessary to refine RA technique selection.
  • Optimizing RA strategies can enhance clinical outcomes in obese surgical patients.