Linear Anesthesia

00:05 In this video, I'd like to show you the concept of a linear anesthesia.

00:09 Typically done when you have an incision you're going to create.

00:13 The way this works is you simply start from the proximal side of the incision, and you provide a line of a bleb, so to speak.

00:22 So you would inject through the tissue.

00:24 And then as you advance the needle across, above the skin, I'll show you what's happening beneath the skin.

00:30 You basically advancing your needle underneath your wound as you're giving a bleb, and you go as far as you can.

00:36 And then you stop, take your needle out.

00:39 If you need to reload with more lidocaine or whatever you're choosing to use.

00:42 And then you'll pick up where you left off and keep on going inside the tissue until you get to the point where you've met your distal end.

00:50 That way, you have a nice bleb that goes all the way down where your incision is you've covered the patient adequately with linear anesthesia.

00:58 That said, this is option number one for let's say, if you have wounds that you're going to create.

01:04 If the patient presents to you with an incision that's already made, let's say from a laceration from some blunt force trauma, which you can choose to do if you've already gone through the process of cleaning out your wound and providing good anesthesia.

01:17 If necessary prior for something more original for a large laceration with like an anesthesiologist.

01:24 Or if you have something smaller going on here, you may choose to perform this procedure going through the incision outward.

01:31 So if you have a laceration that you feel is appropriate to close, you can actually give anesthesia through this outwards.

01:38 So sometimes what you'll see people do is they'll go in.

01:40 So it's kind of like fanning out like the sun.

01:44 And they'll go through the sidewall, the dermis.

01:47 And the first thing I'd recommend you do if you have a laceration that's open is to drip lidocaine in there, because the skin barrier is already broken, and the pain is already there.

01:56 So you have the benefit of going directly to the deeper dermis with anesthetic.

01:59 Let it kind of sit there for a minute or two, and then go ahead and start fanning out through the sidewalls of the tissue.

02:05 If a wound is clean enough to close, it's cleaned out to get anesthesia through the insides of the incision.

02:11 As opposed to having to make multiple pokes on the outside and penetrate the tissue more.

02:16 You're better to work through the one incision you already have.

02:18 So go ahead and practice this.

02:20 Just to kind of visually understand how to do this with your needle and syringe.

02:25 Again, it won't actually react in the tissue as well.

02:27 It's not going to bleob up for you. But you understand the concept that want to least do the proper hand movement.

02:31 So go ahead and practice that on your own.