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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

597
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...
597

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Ultrasound-Guided Regional Anesthesia in Permanent Pacemaker Implantation: An Observational Study.

Hakan Akelma1, Enes Çelik1, Yusuf İpek2

  • 1Department of Anesthesiology and Reanimation, Mardin Artuklu University, Mardin 47100, Turkey.

Medicina (Kaunas, Lithuania)
|June 27, 2025
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Summary

Combining interscalene brachial plexus block (ISB) and superficial cervical plexus block (SCPB) provides superior pain control for pacemaker implantation compared to local anesthesia (LA). This regional anesthesia approach enhances patient satisfaction and reduces analgesic needs.

Keywords:
local anesthesiapacemaker implantationpain managementperipheral nerve blocksregional anesthesia

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Medical Devices

Background:

  • Pacemaker implantation is a common procedure performed annually worldwide.
  • Local anesthesia (LA) is the standard, but often results in inadequate pain management.
  • Improved anesthesia techniques are needed for better patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of combined interscalene brachial plexus block (ISB) and superficial cervical plexus block (SCPB) for permanent pacemaker implantation.
  • To compare this regional anesthesia (RA) technique against traditional local anesthesia (LA).

Main Methods:

  • A comparative study involving 42 patients undergoing permanent pacemaker implantation.
  • Patients were randomized into two groups: RA (ISB + SCPB under ultrasound guidance) and LA.
  • Ultrasound guidance was utilized for the RA group to enhance precision.

Main Results:

  • The RA group demonstrated significantly better pain control compared to the LA group.
  • Patients receiving RA required fewer additional analgesics.
  • Higher patient satisfaction rates were reported in the RA group.
  • Ultrasound guidance improved block success and reduced complications.

Conclusions:

  • Combined ISB and SCPB represent a superior regional anesthesia alternative to LA for pacemaker procedures.
  • This RA technique is particularly beneficial for anxious patients or those with inadequate response to LA.
  • Ultrasound-guided RA enhances safety and efficacy in pacemaker implantation.