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Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical purposes. It may include some or all of analgesia, paralysis, amnesia, and unconsciousness. A person under the effects of anesthetic drugs is referred to as being anesthetized.
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia.
A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general anesthetic. When it is used on specific nerve pathways, paralysis also can be achieved.
Lidocaine, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type. It is also used to treat ventricular tachycardia. When used for local anaesthesia or in nerve blocks, lidocaine typically begins working within several minutes and lasts for half an hour to three hours. Lidocaine mixtures may also be applied directly to the skin or mucous membranes to numb the area. It is often used mixed with a small amount of adrenaline (epinephrine) to prolong its local effects and to decrease bleeding.
General anaesthesia (UK) or general anesthesia (US) is a medically induced coma with loss of protective reflexes, resulting from the administration of either intravenous or inhalational general anaesthetic medications, often in combination with an analgesic and neuromuscular blocking agent. It is generally performed in an operating theater to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients.
Spinal anaesthesia, also called spinal block, subarachnoid block, intradural block and intrathecal block, is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long. It is a safe and effective form of anesthesia usually performed by anesthesiologists that can be used as an alternative to general anesthesia commonly in surgeries involving the lower extremities and surgeries below the umbilicus. The local anesthetic with or without an opioid injected into the cerebrospinal fluid provides locoregional anaesthesia: true analgesia, motor, sensory and autonomic (sympathic) blockade. Administering analgesics in the cerebrospinal fluid without a local anaesthetic produces locoregional analgesia: markedly reduced pain sensation, some autonomic blockade, but no sensory or motor block. Locoregional analgesia, due to mainly the absence of motor and sympathic block may be preferred over locoregional anaesthesia in some postoperative care settings. The tip of the spinal needle has a point or small bevel. Recently, pencil point needles have been made available.
Awareness under anesthesia, also referred to as intraoperative awareness or accidental awareness during general anesthesia (AAGA), is a rare complication of general anesthesia where patients regain varying levels of consciousness during their surgical procedures. While anesthesia awareness is possible without resulting in any long-term memory, it is also possible for the victim to have awareness with explicit recall, where victims can remember the events related to their surgery.
Epidural administration is a method of medication administration in which a medicine is injected into the epidural space around the spinal cord. The epidural route is used by physicians and nurse anesthetists to administer local anesthetic agents, analgesics, diagnostic medicines such as radiocontrast agents, and other medicines such as glucocorticoids. Epidural administration involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. The technique of intentional epidural administration of medication was first described in 1921 by Spanish military surgeon Fidel Pagés. In the United States, over 50% of childbirths involve the use of epidural anesthesia.
A thoracotomy is a surgical procedure to gain access into the pleural space of the chest. It is performed by surgeons to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine. A thoracotomy is the first step in thoracic surgeries including lobectomy or pneumonectomy for lung cancer or to gain thoracic access in major trauma.
Infiltration analgesia is deposition of an analgesic drug close to the apex of a tooth so that it can diffuse to reach the nerve entering the apical foramina. It is the most routinely used in dental local treatment.
Bupivacaine, marketed under the brand name Marcaine among others, is a medication used to decrease feeling in a specific area. In nerve blocks, it is injected around a nerve that supplies the area, or into the spinal canal's epidural space. It is available mixed with a small amount of epinephrine to increase the duration of its action. It typically begins working within 15 minutes and lasts for 2 to 8 hours.
Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve. Neurolytic block, the deliberate temporary degeneration of nerve fibers through the application of chemicals, heat, or freezing, produces a block that may persist for weeks, months, or indefinitely. Neurectomy, the cutting through or removal of a nerve or a section of a nerve, usually produces a permanent block. Because neurectomy of a sensory nerve is often followed, months later, by the emergence of new, more intense pain, sensory nerve neurectomy is rarely performed.
Articaine is a dental amide-type local anesthetic. It is the most widely used local anesthetic in a number of European countries and is available in many countries. It is the only local anaesthetic to contain a thiophene ring, meaning it can be described as 'thiophenic'; this conveys lipid solubility.
Chloroprocaine is a local anesthetic given by injection during surgical procedures and labor and delivery. Chloroprocaine vasodilates; this is in contrast to cocaine which vasoconstricts. Chloroprocaine is an ester anesthetic.
Dental anesthesia is the application of anesthesia to dentistry. It includes local anesthetics, sedation, and general anesthesia.
Continuous wound infiltration (CWI) refers to the continuous infiltration of a local anesthetic into a surgical wound to aid in pain management during post-operative recovery.
Brachial plexus block is a regional anesthesia technique that is sometimes employed as an alternative or as an adjunct to general anesthesia for surgery of the upper extremity. This technique involves the injection of local anesthetic agents in close proximity to the brachial plexus, temporarily blocking the sensation and ability to move the upper extremity. The subject can remain awake during the ensuing surgical procedure, or they can be sedated or even fully anesthetized if necessary.
The following outline is provided as an overview of and topical guide to anesthesia:
Local anesthetic nerve block is a short-term nerve block involving the injection of local anesthetic as close to the nerve as possible for pain relief. The local anesthetic bathes the nerve and numbs the area of the body that is supplied by that nerve. The goal of the nerve block is to prevent pain by blocking the transmission of pain signals from the surgical site. The block provides pain relief during and after the surgery. The advantages of nerve blocks over general anesthesia include faster recovery, monitored anesthesia care vs. intubation with an airway tube, and much less postoperative pain.
A femoral nerve block is a nerve block that uses local anesthetic to achieve analgesia in the leg. The block works by affecting the femoral nerve.
References
- 1 2 3 Mallinson, Tom (2019). "Fascia iliaca compartment block: a short how-to guide". Journal of Paramedic Practice. 11 (4): 154–155. doi:10.12968/jpar.2019.11.4.154. ISSN 1759-1376.
- 1 2 3 4 Steenberg, J.; Møller, A.M. (April 2018). "Systematic review—effects of fascia iliaca compartment block on hip fractures before operation". British Journal of Anaesthesia. 120 (6): 1368–1380. doi: 10.1016/j.bja.2017.12.042 . PMID 29793602.
- 1 2 Dalens, B; Vanneuville, G; Tanguy, A (December 1989). "Comparison of the fascia iliaca compartment block with the 3-in-1 block in children". Anesthesia & Analgesia. 69 (6): 705–13. doi:10.1213/00000539-198912000-00003. PMID 2589650.
- ↑ Chesters, A; Atkinson, P (October 2014). "Fascia iliaca block for pain relief from proximal femoral fracture in the emergency department: a review of the literature". Emergency Medicine Journal. 31 (e1): e84–7. doi:10.1136/emermed-2013-203073. PMID 24389648.
- ↑ Pinson, S (October 2015). "Fascia Iliaca (FICB) block in the emergency department for adults with neck of femur fractures: A review of the literature". International Emergency Nursing. 23 (4): 323–8. doi:10.1016/j.ienj.2015.03.002. PMID 25956668.
- ↑ Black, Karen JL; Bevan, Catherine A; Murphy, Nancy G; Howard, Jason J (17 December 2013). "Nerve blocks for initial pain management of femoral fractures in children". Cochrane Database of Systematic Reviews (12): CD009587. doi:10.1002/14651858.CD009587.pub2. PMID 24343768.
- ↑ Shelley, Benjamin G.; Haldane, Grant J. (1 November 2006). "Pneumoretroperitoneum as a Consequence of Fascia Iliaca Block". Regional Anesthesia and Pain Medicine. 31 (6): 582–583. doi:10.1016/j.rapm.2006.08.009. ISSN 1098-7339. PMID 17138203.
- ↑ Blackford, D; Westhoffen, P (January 2009). "Accidental bladder puncture: a complication of a modified fascia iliaca block". Anaesthesia and Intensive Care. 37 (1): 140–1. PMID 19157368.
- ↑ Atchabahian, A; Brown, AR (March 2001). "Postoperative neuropathy following fascia iliaca compartment blockade". Anesthesiology. 94 (3): 534–6. doi:10.1097/00000542-200103000-00029. PMID 11374619.
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