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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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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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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

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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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Peripheral Artery Disease III: Interprofessional Care01:27

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Updated: Apr 3, 2026

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat
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Utility of Peripheral Nerve Block in Lower Extremity Amputation.

Samuel C Onyewu1, David Yanez2, Jude Nnamdi3

  • 1Department of Anesthesiology and Critical Care Medicine, George Washington University/George Washington University Hospital, Washington, DC, USA.

Journal of Pain Research
|April 2, 2026
PubMed
Summary

Peripheral nerve blocks (PNB) show promise in reducing opioid use and operative time for lower extremity amputations (LEA). While not statistically significant, PNB may help prevent phantom limb pain (PLP), warranting further study.

Keywords:
lower extremity amputationperipheral nerve blockphantom limb painprimary anesthetic

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Area of Science:

  • Anesthesiology
  • Surgical Outcomes
  • Pain Management

Background:

  • Lower extremity amputation (LEA) affects nearly two million Americans annually.
  • Phantom limb pain (PLP) is a common complication, leading to significant healthcare costs.
  • Optimal anesthetic techniques for LEA and PLP prevention remain under investigation.

Purpose of the Study:

  • To evaluate the effectiveness of peripheral nerve block (PNB) as a primary anesthetic modality for LEA.
  • To compare perioperative outcomes, including PLP incidence, between PNB and general anesthesia (GA).

Main Methods:

  • Retrospective review of 179 adult patients undergoing first-time LEA.
  • Stratification by anesthetic technique: GA, PNB, neuraxial, or GA combined with PNB.
  • Analysis of PLP incidence, hospital stay, opioid use, and operative time.

Main Results:

  • PNB use was associated with reduced opioid requirements and operative time.
  • No statistically significant difference in PLP incidence between GA and GA+PNB groups.
  • Zero PLP cases observed in the small PNB-alone group.

Conclusions:

  • PNB demonstrates potential benefits for LEA, including decreased opioid consumption and shorter operative durations.
  • PNB shows promising results for PLP prevention, meriting further investigation.
  • Prospective randomized trials are recommended to confirm PNB's efficacy as a primary anesthetic for LEA.