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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

821
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...
821
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

509
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...
509
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

606
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...
606

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Updated: Sep 19, 2025

Author Spotlight: Minimally Invasive Relief for Occipital Neuralgia at the Nuchal Line
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Decrease in opioid use and spinal interventions after basivertebral nerve ablation.

Andrew R Stephens1, Adem F Aktas1, Ramzi El-Hassan1

  • 1University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14623, United States of America.

Interventional Pain Medicine
|June 16, 2025
PubMed
Summary
This summary is machine-generated.

Basivertebral nerve radiofrequency ablation (BVNRFA) reduces chronic back pain, leading to decreased opioid use and fewer spine interventions post-procedure. This study confirms BVNRFA

Keywords:
Basivertebral nerve ablationLow back painLumbar spine surgeryOpioidsVertebrogenic pain

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Area of Science:

  • Pain Management
  • Interventional Pain Medicine
  • Health Services Research

Background:

  • Basivertebral nerve radiofrequency ablation (BVNRFA) is an effective treatment for chronic back pain in select patients.
  • Understanding the impact of BVNRFA on healthcare utilization is crucial for patient management and resource allocation.

Purpose of the Study:

  • To evaluate healthcare utilization outcomes, including opioid use and spine interventions, following BVNRFA.
  • To assess the rate of spine surgery within one year after BVNRFA in a large patient cohort.

Main Methods:

  • A retrospective analysis of a global health research network database (TriNetX) from 2022 to 2025.
  • Inclusion of patients who underwent BVNRFA, with data on opioid use and spine interventions recorded one year pre- and post-procedure.
  • Statistical comparison using chi-square tests, with significance set at p < 0.05.

Main Results:

  • A total of 1,118 patients underwent BVNRFA.
  • Post-procedure opioid use decreased significantly (57% to 51%, p=0.006).
  • Spine interventions, including various steroid injections and radiofrequency ablations, significantly decreased post-BVNRFA (p < 0.001 for all).
  • Low rates of spine surgery were observed within one year post-BVNRFA, with only 47 patients undergoing procedures like lumbar fusion.

Conclusions:

  • BVNRFA is associated with significant reductions in opioid consumption and spine interventions within one year post-procedure.
  • The study highlights the favorable healthcare utilization profile of BVNRFA, with minimal rates of subsequent spine surgery.