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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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

Local Anesthetics: Clinical Application as Epidural Anesthesia

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

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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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...
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General Anesthesia: Overview01:24

General Anesthesia: Overview

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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...
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Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

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The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
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Spinal Anesthesia and Regional Hemodynamic Parameters.

Dilan Taş1, Yavuz Kelleci2, Tumay Umuroğlu2

  • 1Department of Anesthesiology and Reanimation, Erciş Şehit Rıdvan Çevik State Hospital, Van, Turkey.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|October 8, 2025
PubMed
Summary
This summary is machine-generated.

Spinal anesthesia (SA) increases posterior tibial artery (PTA) blood flow, as measured by pulsed-wave Doppler (PWD) ultrasonography. These findings suggest PWD can help assess SA block success.

Keywords:
Dopplerblock successpulsed wavespectral wavesubarachnoidultrasonography

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Area of Science:

  • Vascular ultrasonography
  • Anesthesiology
  • Hemodynamics

Background:

  • Spinal anesthesia (SA) induces sympathectomy in lower extremities, leading to increased arterial blood flow.
  • Pulsed-wave Doppler (PWD) ultrasonography (USG) can detect these hemodynamic changes.
  • The posterior tibial artery (PTA) is a key vessel for assessing lower extremity blood flow.

Purpose of the Study:

  • To investigate changes in PTA blood flow parameters using PWD after SA.
  • To determine if PWD measurements correlate with the success of SA block.
  • To test the hypothesis that SA increases systolic and diastolic flow velocities in the PTA.

Main Methods:

  • Thirty patients aged 18-65 undergoing elective surgery with SA were included.
  • USG with PWD was used to measure PTA diameter and Doppler parameters (PSV, EDV, Vmn, S/D, PI, RI).
  • Measurements were taken before and at 5 and 10 minutes after SA administration.

Main Results:

  • SA altered PTA spectral waveforms from triphasic to monophasic.
  • Vessel diameter and flow velocities (PSV, EDV, Vmn) significantly increased post-SA (p < .001).
  • Pulsatility index (PI), resistive index (RI), and S/D ratio significantly decreased post-SA (p < .001), correlating with block depth.

Conclusions:

  • SA significantly alters PTA spectral waveform, diameter, and Doppler flow velocity parameters.
  • PWD assessment of PTA shows promise as a supplementary tool for evaluating SA block success.
  • This technique is particularly useful in patients with communication barriers where SA is used.