ANATOMY OF SPINAL CORD

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ANATOMY OF SPINAL CORD
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SPINAL ANESTHESIA
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ANAESTHETICS USED

• HYPERBARIC (HEAVY)?
• LIGNOCAINE 5 IN 7.5DEXTROSE
• BUPIVACAINE 0.5 IN 5 DEXTROSE

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HOW A HEAVY ANAESTHETICSOLUTION FLOWS IN CSF
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INDICATIONS

• Fit patient requiring lower abdominal, anal of
  lower extremity surgery
• A patient having relative contraindication to
  general anaesthesia eg respiratory infection,
  asthma, or a deformed airway
• Operations where the patient needs to be placed
  prone eg excision pilonidal sinus
• Operations of one lower extremity ( hemispinal)?

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CONTRAINDICATIONS

• Unco-operative patient
• Operations lasting more than 2 hours
• Hypovolemic shock
• Children
• Sepsis anywhere on the back
• Operations on the thorax and above

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TECHNIQUE

• Preload with 500- 1000ml crystalloid
• Premedicate pentazocine,prometazine, atropine
• Moniter BP,pulse and O2 sat, heart rhythm

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COMPLICATIONS

• IMMEDIATE
• Hypotension- increase IV fluids, use small doses
  of vasoconstrictors eg mephenteramine ( 3mg iv as
  needed)?
• Bradycardia- iv atropine
• Respiratory distress- supplement with O2, bag and
  mask or intubate
• Inadequate block supplement with IV ketamine
• Total spinal
• LATE
• Headache
• Meningitis
• Back pain