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

564
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...
564
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

778
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...
778
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

498
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...
498
Flail Chest-II01:26

Flail Chest-II

235
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:
235

You might also read

Related Articles

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

Sort by
Same author

The provision of palliative care: A Western Trauma Association critical decisions algorithm.

The journal of trauma and acute care surgery·2026
Same author

Buprenorphine analgesia: Impacts on opioid burden and clinical trajectory in acute trauma care.

The journal of trauma and acute care surgery·2026
Same author

Evaluating Blunt Cerebrovascular Injury Screening in High-Energy Trauma Patients: A Rural Trauma Center Study.

The Journal of surgical research·2026
Same author

How Timing of Regional Anesthesia Impacts Outcomes in Traumatic Rib Fracture Patients: A Trauma Quality National Improvement Program-Based Study.

The Journal of surgical research·2026
Same author

Severe Obesity Management in a Large Academic Health System: A Retrospective Evaluation of Metabolic Bariatric Surgery Counselling Practices.

Clinical obesity·2026
Same author

A Community-Based Trauma-Informed Care Curriculum on Women's Health for Third-Year Medical Students.

MedEdPORTAL : the journal of teaching and learning resources·2026

Related Experiment Video

Updated: Sep 12, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

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

Published on: May 26, 2023

1.7K

Should We Utilize Regional Anesthesia for Traumatic Rib Fracture Patients? A TQIP-Based Study.

Marina Levochkina1, Carter Colwell2, Taneen Maghsoudi2

  • 1Virginia Tech Carilion School of Medicine, Roanoke, Virginia.

The Journal of Surgical Research
|August 8, 2025
PubMed
Summary

Regional anesthesia for rib fractures did not impact mortality. However, it was linked to longer hospital stays and increased intensive care unit (ICU) admissions, including unplanned intubations and ICU transfers.

Keywords:
EpiduralFlail chestPain managementRegional anesthesiaRib fractureTQIPTrauma

More Related Videos

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
06:57

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Published on: September 13, 2020

3.2K
Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management
03:53

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

Published on: March 15, 2024

2.0K

Related Experiment Videos

Last Updated: Sep 12, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

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

Published on: May 26, 2023

1.7K
Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
06:57

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Published on: September 13, 2020

3.2K
Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management
03:53

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

Published on: March 15, 2024

2.0K

Area of Science:

  • Trauma Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Rib fractures are common in trauma, leading to severe complications like pneumonia and mortality.
  • Multimodal analgesia, with or without regional anesthesia, is standard care for rib fracture pain management.
  • Previous single-institution studies on regional anesthesia effectiveness yielded mixed results.

Purpose of the Study:

  • To evaluate the association between regional anesthesia and in-hospital mortality for isolated rib fractures.
  • To assess secondary outcomes, including hospital complications and resource utilization (ventilator, ICU, and hospital length of stay).
  • To leverage national trauma registry data for a large-scale analysis.

Main Methods:

  • Utilized the 2021 Trauma Quality Improvement Program (TQIP) national registry.
  • Identified patients with isolated chest trauma and categorized them by receipt of regional anesthesia (epidural or peripheral nerve block) or no regional anesthesia.
  • Employed propensity matching to compare outcomes between the two groups.

Main Results:

  • After propensity matching, 1295 patients were analyzed in each group (regional anesthesia vs. no regional anesthesia).
  • No significant difference in in-hospital mortality was observed between the groups.
  • Regional anesthesia was associated with increased hospital length of stay, ICU admissions, unplanned intubations, and unplanned ICU upgrades.

Conclusions:

  • Regional anesthesia for rib fracture management, based on TQIP data, did not demonstrate a reduction in mortality.
  • The use of regional anesthesia was correlated with increased resource utilization, including longer hospital stays and higher rates of ICU admission and intervention.
  • Further research is recommended to identify specific patient subgroups who may benefit from regional anesthesia techniques.