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Caudal anaesthesia is a relatively low-risk technique [4] commonly used, either on its own or in combination with sedation or general anaesthesia. [3] [5]Caudal anesthesia may be favored for sub-umbilical region surgeries in the pediatric population, such as inguinal hernia repair, circumcision, hypospadias repair, anal atresia, or to immobilise newborns with hip dysplasia.
Protocols vary depending on local standard procedures and the extremity being operated on. A vast majority of practitioners begin by exsanguinating the limb as Bier did with an elastic bandage (Esmarch bandage), squeezing blood proximally toward the heart, then pneumatic tourniquets are applied to the limb and inflated 30mmHg above arterial pressure to occlude all blood vessels and then the ...
Many local anesthetics fall into two general chemical classes, amino esters (top) and amino amides (bottom). A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, [1] providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes ...
The first planned spinal anaesthesia for surgery on a human was administered by August Bier (1861–1949) on 16 August 1898, in Kiel, when he injected 3 ml of 0.5% cocaine solution into a 34-year-old labourer. [14] After using it on six patients, he and his assistant each injected cocaine into the other's spine. They recommended it for ...
Nerve blocks are also used as a continuous infusion, following major surgery such as knee, hip and shoulder replacement surgery, and may be associated with lower complications. [13] Nerve blocks are also associated with a lower risk of neurologic complications compared to the more central epidural or spinal neuraxial blocks. [2]: 1639–41
Neuraxial blockade is local anaesthesia placed around the nerves of the central nervous system, such as spinal anaesthesia, caudal anaesthesia, epidural anaesthesia, and combined spinal and epidural anaesthesia. [1] [2] The technique is used in surgery, obstetrics, and for postoperative and chronic pain relief. [3]
Bupivacaine is indicated for local infiltration, peripheral nerve block, sympathetic nerve block, and epidural and caudal blocks. It is sometimes used in combination with epinephrine to prevent systemic absorption and extend the duration of action. The 0.75% (most concentrated) formulation is used in retrobulbar block. [13]
Twilight anesthesia is applied to various types of medical procedures and surgeries. It is a popular choice among surgeons and doctors who are performing anything from minor plastic surgeries to dental work, and procedures that do not require extensive operations or long durations in favor of less nausea and a limited recovery period after surgery.