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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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

Local Anesthetics: Clinical Application as Spinal Anesthesia

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

Local Anesthetics: Clinical Application as Epidural Anesthesia

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...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

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...
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Mechanism of Action01:23

Local Anesthetics: Mechanism of Action

Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...

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Related Experiment Videos

Local Anesthesia for Complex F/BEVAR in a High-Risk Cohort: A Single-Center Feasibility Study.

Natasha Hasemaki1, Ihza Fachriza1,2,3, Jan Stana1

  • 1Department of Vascular Surgery, University Hospital LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.

Journal of Clinical Medicine
|May 13, 2026
PubMed
Summary

Local anesthesia (LA) for fenestrated and branched endovascular aortic repair (F/BEVAR) may be feasible in select high-risk patients. However, higher complication rates were observed, warranting further investigation into safety and efficacy compared to general anesthesia (GA).

Keywords:
branched EVARcomplex aorticfenestrated EVARlocal anesthesia

Related Experiment Videos

Area of Science:

  • Vascular Surgery
  • Anesthesiology
  • Medical Device Technology

Background:

  • Fenestrated and branched endovascular aortic repair (F/BEVAR) is an advanced treatment for complex aortic aneurysms.
  • General anesthesia (GA) is the traditional anesthetic approach for F/BEVAR, but data on local anesthesia (LA) is limited.
  • This study investigates the early outcomes of F/BEVAR performed under LA versus GA in a high-risk population.

Purpose of the Study:

  • To assess the feasibility and early outcomes of F/BEVAR performed under local anesthesia (LA).
  • To compare perioperative complications between LA and general anesthesia (GA) for F/BEVAR.
  • To evaluate technical success, reintervention rates, and resource utilization in both anesthetic groups.

Main Methods:

  • A single-center retrospective analysis of 359 patients undergoing F/BEVAR.
  • Patients were categorized into two groups: those treated under LA (n=25) and those under GA (n=334).
  • Primary outcomes included in-hospital mortality and complications; secondary outcomes included reintervention, length of stay, and transfusion requirements.

Main Results:

  • The LA group had higher baseline risk factors, including advanced age and emergency/ruptured repairs.
  • In-hospital complications were more frequent in the LA group (68.0% vs. 41.3%), including a higher rate of spinal cord ischemia (24.0% vs. 8.5%).
  • Early reintervention rates were also higher in the LA group (31.8% vs. 10.4%), despite comparable blood loss and length of stay.

Conclusions:

  • Local anesthesia (LA) may be feasible for selected high-risk patients undergoing complex F/BEVAR.
  • However, the observed higher complication and reintervention rates in the LA group suggest caution.
  • Substantial baseline differences preclude definitive conclusions on comparative safety and efficacy versus general anesthesia (GA).