Regional Anesthesia
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Regional Anesthesia
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, i.e. 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. The following terms are often used interchangeably: * ''Local anesthesia'', in a strict sense, is anesthesia of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' encompasses a great variety of local and regional anesthetic techniques. Medical A local anesthetic is a drug that causes reversible local anesthesia and a loss of nociception. When it is used on specific nerve pathways (nerve block), effects such as an ...
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Sense
A sense is a biological system used by an organism for sensation, the process of gathering information about the surroundings through the detection of Stimulus (physiology), stimuli. Although, in some cultures, five human senses were traditionally identified as such (namely Visual perception, sight, Olfaction, smell, Somatosensory system, touch, taste, and hearing), many more are now recognized. Senses used by non-human organisms are even greater in variety and number. During sensation, sense organs collect various stimuli (such as a sound or smell) for Transduction (physiology), transduction, meaning transformation into a form that can be understood by the brain. Sensation and perception are fundamental to nearly every aspect of an organism's cognition, behavior and thought. In organisms, a sensory organ consists of a group of interrelated Sensory neuron, sensory cells that respond to a specific type of physical stimulus. Via Cranial nerves, cranial and spinal nerves (nerves ...
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Pharmacology
Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics, pharmacodynamics, therapeutic use, and toxicology. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function. If substances have medicinal properties, they are considered pharmaceuticals. The field encompasses drug composition and properties, functions, sources, synthesis and drug design, molecular and cellular mechanisms, organ/systems mechanisms, signal transduction/cellular communication, molecular diagnostics, interactions, chemical biology, therapy, and medical applications and antipathogenic capabilities. The two main areas of pharmacology are pharmacodynamics and pharmacokinetics. Pharmacodynamics studies the effects of a drug on biological systems, and pharmacokinetics studies the effects of biological systems on a drug. In broad terms, pharmacod ...
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James Leonard Corning
James Leonard Corning (1855 – 1923) was an American neurologist, mainly known for his early experiments on neuraxial blockade in New York City. Education Corning was born in Stamford, Connecticut. When the American Civil War began in 1861, Corning's family moved to Stuttgart, Germany. Corning studied chemistry at the Stuttgart Polytechnic Institute under Hermann von Fehling. He later studied physiology at Heidelberg University under Wilhelm Kühne, and pathology at the University of Würzburg. After receiving his medical degree in 1878, he left Germany and visited Vienna, Paris, and London before finally returning to the United States. Neuraxial blockade In 1884, Karl Koller became the first to describe the anesthetic properties of cocaine. The following year, Corning injected cocaine between the spinous processes of the lower lumbar vertebrae, first in a dog and then in a healthy man. His experiments are the first published descriptions of the principle of neuraxia ...
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August Bier
August Karl Gustav Bier (24 November 1861 – 12 March 1949) was a German surgeon. He was the first to perform spinal anesthesia and intravenous regional anesthesia. Early medical career Bier began his medical education at the Charité – Universitätsmedizin Berlin in 1881, transferred to the Leipzig University in 1882, and transferred again to the University of Kiel in 1883. After receiving his medical degree from the University of Kiel in 1886, Bier worked as a general practitioner and ship's surgeon just outside the city of Kiel – which is a major port on the Baltic Sea. Bier began his residency in 1888 at the surgical clinic at the University of Kiel, under the mentorship of Friedrich von Esmarch. After professorships in Greifswald and University of Bonn, Bonn, Bier was appointed Chief Surgeon and Geheimrat Professor of Surgery at the Charité - Universitätsmedizin. Spinal anesthesia On 16 August 1898, Bier performed the first operation under spinal anesthesia at ...
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Karl Koller (ophthalmologist)
Karl Koller (December 3, 1857 – March 21, 1944) was an Austrian ophthalmologist. He began his medical career as a surgeon at the Vienna General Hospital and a colleague of Sigmund Freud. Biography Koller introduced cocaine as a local anaesthetic for eye surgery. Prior to this discovery, he had tested solutions such as chloral hydrate and morphine as anaesthetics in the eyes of laboratory animals without success. Freud was fully aware of the pain-killing properties of cocaine, but Koller recognized its tissue-numbing capabilities, and in 1884 demonstrated its potential as a local anaesthetic to the medical community. Koller's findings were a medical breakthrough. Prior to his discovery, performing eye surgery was difficult because the involuntary reflex motions of the eye to respond to the slightest stimuli. Later, cocaine was also used as a local anaesthetic in other medical fields such as dentistry. In the 20th century, other agents such as lidocaine have replaced cocaine as a ...
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Abscess
An abscess is a collection of pus that has built up within the tissue of the body, usually caused by bacterial infection. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends beyond the swelling. Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger. A cyst is related to an abscess, but it contains a material other than pus, and a cyst has a clearly defined wall. Abscesses can also form internally on internal organs and after surgery. They are usually caused by a bacterial infection. Often many different types of bacteria are involved in a single infection. In many areas of the world, the most common bacteria present is ''methicillin-resistant Staphylococcus aureus''. Rarely, parasites can cause abscesses; this is more common in the developing world. Diagnosis of a skin abscess is usually made based on what it looks ...
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Local Anesthetic Toxicity
A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes unconsciousness. Local anesthetics are most commonly used to eliminate pain during or after surgery. When it is used on specific nerve pathways ( local anesthetic nerve block), paralysis (loss of muscle function) also can be induced. Classification LAs are of 2 types: *Clinical LAs: ** amino amide LAs ** amino ester LAs *Synthetic LAs **Cocaine derivatives Synthetic cocaine-derived LAs differ from cocaine because they have a much lower abuse potential and do not cause hypertension vasoconstriction (with few exceptions). The suffix "-caine" at the ends of these medication names is derived from the word "cocaine", because cocaine was formerly used as a local anesthetic. Examples Short Duration of Action ...
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Cyanosis
Cyanosis is the change of Tissue (biology), tissue color to a bluish-purple hue, as a result of decrease in the amount of oxygen bound to the hemoglobin in the red blood cells of the capillary bed. Cyanosis is apparent usually in the Tissue (biology), body tissues covered with thin skin, including the mucous membranes, lips, nail beds, and ear lobes. Some medications may cause discoloration such as medications containing amiodarone or silver. Furthermore, mongolian spots, large birthmarks, and the consumption of food products with blue or purple dyes can also result in the bluish skin tissue discoloration and may be mistaken for cyanosis. Appropriate physical examination and history taking is a crucial part to diagnose cyanosis. Management of cyanosis involves treating the main cause, as cyanosis is not a disease, but rather a symptom. Cyanosis is further classified into central cyanosis and peripheral cyanosis. Pathophysiology The mechanism behind cyanosis is different dep ...
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Vasovagal Episode
Reflex syncope is a brief loss of consciousness due to a neurologically induced drop in blood pressure and/or a decrease in heart rate. Before an affected person passes out, there may be sweating, a decreased ability to see, or ringing in the ears. Occasionally, the person may twitch while unconscious. Complications of reflex syncope include injury due to a fall. Reflex syncope is divided into three types: vasovagal, situational, and carotid sinus. Vasovagal syncope is typically triggered by seeing blood, pain, emotional stress, or prolonged standing. Situational syncope is often triggered by urination, swallowing, or coughing. Carotid sinus syncope is due to pressure on the carotid sinus in the neck. The underlying mechanism involves the nervous system slowing the heart rate and dilating blood vessels, resulting in low blood pressure and thus not enough blood flow to the brain. Diagnosis is based on the symptoms after ruling out other possible causes. Recovery from a ...
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Central Nervous System
The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain, spinal cord and retina. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all parts of the bodies of bilateria, bilaterally symmetric and triploblastic animals—that is, all multicellular animals except sponges and Coelenterata, diploblasts. It is a structure composed of nervous tissue positioned along the Anatomical_terms_of_location#Rostral,_cranial,_and_caudal, rostral (nose end) to caudal (tail end) axis of the body and may have an enlarged section at the rostral end which is a brain. Only arthropods, cephalopods and vertebrates have a true brain, though precursor structures exist in onychophorans, gastropods and lancelets. The rest of this article exclusively discusses the vertebrate central nervous system, which is radically distinct from all other animals. Overview In vertebrates, the brain and spinal ...
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Hematoma
A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillaries. A hematoma is benign and is initially in liquid form spread among the tissues including in sacs between tissues where it may coagulate and solidify before blood is reabsorbed into blood vessels. An ecchymosis is a hematoma of the skin larger than 10 mm. They may occur among and or within many areas such as skin and other organs, connective tissues, bone, joints and muscle. A collection of blood (or even a hemorrhage) may be aggravated by anticoagulant medication (blood thinner). Blood seepage and collection of blood may occur if heparin is given via an intramuscular route; to avoid this, heparin must be given intravenously or subcutaneously. Signs and symptoms Some hematomas are visible under the surface of the skin (commonly called bruise ...
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Paresthesia
Paresthesia is a sensation of the skin that may feel like numbness (''hypoesthesia''), tingling, pricking, chilling, or burning. It can be temporary or Chronic condition, chronic and has many possible underlying causes. Paresthesia is usually painless and can occur anywhere on the body, but most commonly in the arms and legs. The most familiar kind of paresthesia is the sensation known as ''pins and needles'' after having a limb "fall asleep" (''obdormition''). A less common kind is formication, the sensation of insects crawling on the skin. Causes Transient Paresthesias of the hands, feet, legs, and arms are common transient symptoms. The briefest electric shock type of paresthesia can be caused by tweaking the ulnar nerve near the elbow; this phenomenon is colloquially known as bumping one's "funny bone". Similar brief shocks can be experienced when any other nerve is tweaked (e.g. a pinched neck nerve may cause a brief shock-like paresthesia toward the scalp). In the older a ...
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