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Local Anesthetics: Clinical Application as Spinal Anesthesia

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 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...

Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

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.

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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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...

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Prone Lateral Minimally Invasive Retropleural Corpectomy Using a Rotatable Radiolucent Jackson Table

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Spinal Anesthesia in the Prone Position: A Case Series.

Beatriz Xavier¹, Cristina P Sousa², Susana Maia¹

¹Anesthesiology, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, Vila Real, PRT.

|June 15, 2026

Summary

Spinal anesthesia in the prone position offers a safe and effective alternative for pilonidal sinus surgery. This technique avoids repositioning complications and achieves high success rates with minimal adverse events.

Keywords:

cerebrospinal fluid neuraxial anesthesia pilonidal sinus prone position spinal anaesthesia

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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

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Published on: January 31, 2025

Area of Science:

Anesthesiology
Surgical Techniques

Background:

Spinal anesthesia (SA) is a preferred anesthetic method due to its safety and efficacy.
Traditional SA requires patient repositioning, which can introduce technical challenges and unpredictable anesthetic spread.
Alternative patient positioning strategies are being explored to mitigate these issues.

Purpose of the Study:

To evaluate the efficacy and safety of spinal anesthesia administered with the patient in the prone position for pilonidal sinus surgery.

Main Methods:

A case series involving 81 patients undergoing pilonidal sinus surgery under SA in the prone position.
Data collection focused on procedural success, anesthetic block adequacy, hemodynamic stability, respiratory status, and complications.

Main Results:

Achieved a 100% overall success rate for the surgical procedure.
Obtained an 86.4% success rate on the first attempt of SA administration.
Reported no instances of hemodynamic instability, respiratory complications, or positioning-related issues.

Conclusions:

SA in the prone position is a safe and effective method for pilonidal sinus surgery.
This approach offers high success rates and a low complication profile.
It presents a viable alternative to traditional SA positioning, simplifying the surgical workflow.