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Related Concept Videos

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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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 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 Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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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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Electroconvulsive Therapy01:30

Electroconvulsive Therapy

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Updated: Mar 6, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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ECTR With Tourniquet and Local Anesthesia Only: Efficiency and Patient Satisfaction.

Kasparas Zilinskas1, Reena Bakshi1, Kristin Clemmons1

  • 1Medical University of South Carolina, Charleston, USA.

Hand (New York, N.Y.)
|March 4, 2026
PubMed
Summary

Local only anesthesia endoscopic carpal tunnel release (LO-ECTR) is significantly faster and more environmentally friendly than operating room endoscopic carpal tunnel release (OR-ECTR). Patient satisfaction with LO-ECTR is high, with mild to moderate pain reported.

Keywords:
ECTRambulatory surgerycarpal tunnelendoscopichand surgerymedian nerve

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Area of Science:

  • Orthopedic Surgery
  • Minimally Invasive Procedures
  • Anesthesia Techniques

Background:

  • Carpal tunnel release (CTR) is often performed under wide-awake local anesthesia no tourniquet (WALANT).
  • Endoscopic carpal tunnel release (ECTR) is typically done in an operating room (OR) under anesthesia (OR-ECTR).
  • This study evaluates ECTR performed under local anesthesia with a tourniquet (LO-ECTR).

Purpose of the Study:

  • To compare procedural efficiency between OR-ECTR and LO-ECTR.
  • To assess the environmental impact of both ECTR techniques.
  • To evaluate patient satisfaction with LO-ECTR.

Main Methods:

  • Retrospective review of 137 LO-ECTR and 104 OR-ECTR cases from June 2021 to June 2023.
  • Efficiency measured by procedure, recovery, and total hospital time.
  • Environmental impact assessed by operating room waste weight; patient satisfaction via postoperative survey.

Main Results:

  • LO-ECTR demonstrated significantly faster times for total procedure, operating, preoperative holding, and recovery compared to OR-ECTR (P < .001).
  • LO-ECTR resulted in substantially lower operating room waste weight (1.3 kg vs 6.0 kg, P < .001).
  • Patients reported mild/moderate pain, with 96.6% overall satisfaction and 98.5% willingness to recommend LO-ECTR.

Conclusions:

  • LO-ECTR is more efficient across all time metrics compared to OR-ECTR.
  • LO-ECTR shows a potential improvement in environmental impact.
  • Further research is needed to evaluate long-term outcomes for LO-ECTR.