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Related Concept Videos

Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

387
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
387
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

537
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
537
Flail Chest-II01:26

Flail Chest-II

240
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
240
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

594
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...
594
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

1.9K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics01:11

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics

536
All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
536

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PECS blocks: where are we now?

Rafael Blanco1

  • 1Pain Division, Anesthesiology Department, Al Corniche Hospital: Corniche Hospital Abu Dhabi, Abu Dhabi, UAE.

Current Opinion in Anaesthesiology
|July 7, 2025
PubMed
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Paravertebral thoracic plane blocks, including PECS blocks, are safe and effective for anesthesia. Recent research highlights their application in breast, thoracic, and cardiac procedures, showing reduced opioid use and improved outcomes.

Keywords:
breast cancerchronic painmultimodal analgesiaregional anesthesiologythoracic painwomen’s health

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Area of Science:

  • Anesthesiology
  • Regional Anesthesia
  • Thoracic Surgery

Background:

  • Thoracic plane blocks are increasingly utilized for analgesia and anesthesia.
  • The Pectoralis Intercostal Plane (PECS) block is a prominent technique within this category.

Purpose of the Study:

  • To provide an updated review of the literature on PECS blocks and other thoracic plane blocks.
  • To summarize recent advancements and applications in the field.

Main Methods:

  • Literature review of studies published within the last two years.
  • Focus on research concerning PECS blocks in various surgical contexts.

Main Results:

  • Recent research (last 2 years) emphasizes PECS block applications in breast cancer, thoracic, and cardiac anesthesia.
  • PECS blocks demonstrate consistent safety, ease of performance, and effectiveness.
  • No complications have been reported with PECS blocks.

Conclusions:

  • PECS blocks are validated by multiple scientific groups for efficacy, including reduced opioid requirements and improved procedural outcomes.
  • Clinicians should consider the benefits and complication rates of regional techniques, including PECS blocks, based on expertise.