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相关概念视频

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

421
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...
421
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

399
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
399
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

107
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.
107
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

591
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...
591
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

345
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
345
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

376
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...
376

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Updated: Jun 11, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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视角: 脊柱外围注射的风险/不良事件

Nancy E Epstein1, Marc A Agulnick2

  • 1Professor of Clinical Neurosurgery, School of Medicine, State University of NY at Stony Brook and Editor-in-Chief Surgical Neurology International NY, USA, and c/o Dr. Marc Agulnick, 1122 Franklin Avenue Suite 106, Garden City, NY, USA.

Surgical neurology international
|October 7, 2024
PubMed
概括

宫和腰部外周脊柱注射对背部疼痛和根基病变没有短期或长期的好处. 这些程序,包括间层注射 (ESI) 和转层注射 (TFESI),也带有不良事件的风险,特别是宫治疗.

关键词:
不良事件 不良事件尾部: 宫部 尾部: 宫部 尾部: 宫部大脑脊髓液 (CSF) 泄漏带绳子注射 带绳子注射腰部 腰部 腰部 腰部神经系统缺陷 神经系统缺陷麻是一种麻.脊柱外注注射: 间膜内注射变形体 (TFESI) 的变形体翻译器 (ESI) 的意思血管内注射 血管内注射

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科学领域:

  • 疼痛管理 疼痛管理
  • 神经外科 神经外科
  • 干预性放射学 干预性放射学

背景情况:

  • 宫和腰部外周脊柱注射是美国常见的疼痛和根结病治疗程序,尽管缺乏FDA批准.
  • 关键类型包括介层注射 (ESI),转层注射 (TFESI) 和尾部注射.
  • 大多数研究表明,与安慰剂相比,短期有效性最小,长期无效.

研究的目的:

  • 评估宫和腰部外周脊柱注射的疗效和安全性.
  • 为了比较不同注射类型和地点之间的不良事件.

主要方法:

  • 对比脊柱外注射 (ESI,TFESI) 与安慰剂的研究进行系统审查.
  • 对与宫和腰部注射相关的报告不良事件 (AE) 的分析.

主要成果:

  • 宫注射显示的不良事件比腰部注射更多.
  • 超注射 (TFESI) 的不良事件比间注射 (ESI) 更严重,特别是在椎.
  • 不良事件包括神经缺陷,中风,感染,血瘤和CSF泄漏.

结论:

  • 脊柱外注注射对宫和腰部疼痛/脊髓病变的短期或长期益处很小,甚至没有.
  • 宫注射与腰部注射相比,具有更高的副作用风险.
  • 超额外的脊髓外周注射与内部注射相比,与更多的不良事件有关.