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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

335
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...
335
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

562
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...
562
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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

916
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...
916
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

400
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...
400
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

378
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...
378

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Updated: May 20, 2025

Simulator Training for Endovascular Neurosurgery
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结合沉浸式模拟与局部麻醉系统毒性和阴茎部区块的协作程序培训:试点研究

Katherine B Griesmer1, Maxwell Thompson1, Briana Miller1

  • 1University of Alabama at Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama.

The western journal of emergency medicine
|March 27, 2025
PubMed
概括

这项试点研究表明,综合的沉浸式和程序模拟培训显著提高了急诊医生住院医生的信心和知识,以执行带 iliaca 隔间块 (FICB) 和管理局部麻醉系统毒性 (LAST). 该培训增强了解剖学可视化,块表现和LAST诊断/管理方面的技能.

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科学领域:

  • 紧急医疗 紧急医疗
  • 医疗模拟 医疗模拟
  • 疼痛管理 疼痛管理

背景情况:

  • 紧急医疗培训需要熟练掌握各种程序和患者演示.
  • 模拟对于罕见的病理和手术至关重要,它补充了现实生活中的暴露.
  • 超声波 (美国) 导向的神经阻塞 (UGNB),就像带阴区块 (FICB),越来越多地被整合到居民课程中.

研究的目的:

  • 评估一种新的,连续的沉浸式和程序模拟对居民FICB和局部麻醉系统毒性 (LAST) 的知识和舒适性的影响.
  • 为了评估居民对他们可视化解剖学,执行FICB和管理LAST后仿真能力的看法.

主要方法:

  • 一项试点研究涉及19名居民 (PGY1-3),他们参与了两个同时进行的1小时模拟,重点是FICB和LAST.
  • 参与者完成了模拟前后调查,以衡量他们感知的知识和舒适度.
  • 斯图尔特-麦克斯韦尔测试被用来分析调查数据的显著变化.

主要成果:

  • 超过一半 (56%) 的参与者缺乏先前的正式FICB培训.
  • 模拟后,在解剖学可视化 (P=0.10),FICB表现 (P=0.08) 和教同行能力 (P=0.20) 的感知信心方面观察到显著的积极趋势.
  • 诊断 (P=0.12) 和管理LAST (P=0.08) 的感知能力也有所改善.

结论:

  • 综合沉浸式和程序模拟提供了一种新有效的方法,用于培训复杂的程序,如FICB和管理关键的并发症,如LAST.
  • 基于模拟的培训增强了居民对程序技能和重症监护场景的信心和感知能力.
  • 这种方法解决了有关交织的程序和重症监护模拟的文献上的差距.