Combine Spinal and Epidural

Question 1

What is the total CSF volume in the spinal cord at any given time?

Answer 1

30-80 cc in the spinal cord at any given time

Question 2

What is the total CSF volume between the brain and spinal cord?

Answer 2

140-150cc at any one time in the entire system

Question 3

Where is the CSF secreted from?

Answer 3

It is secreted by EPENDYMAL cells of the Choroid Plexus within the ventricular system at a rate of 30cc/hr (500 total daily).*

Question 4

What is the total daily amount of CSF secreted?***

Answer 4

500cc total daily***

Question 5

How often is your entire CSF replaced?

Answer 5

Your entire volume of CSF is replaced once every 3-4 hour

Question 6

What is the normal pressure of CSF?

Answer 6

CSF pressure of 10-20 cm H20

Question 7

What is the primary site of action of the LA for both spinals and epidurals?

Answer 7

The NERVE ROOT is the primary site of action of the Local Anesthetics, both with Spinals AND Epidurals. The only difference is WHERE the root is being anesthetized, either Subarachnoid or in the Epidural space

Question 8

What is more predictable? a spinal or epidural?***

Answer 8

Spinal

Question 9

What has 100% of sympathetic blockage that causes hypotension?** a spinal or epidural?

Answer 9

Spinal

Question 10

What spinal needle is sharp and used for cutting?

Answer 10

Quincke

Question 11

What spinal needles are blunt and pencil point?

Answer 11

Whitacre and Sprotte

Question 12

Motor block can range from none to complete, is this statement true for a spinal or epidural block?

Answer 12

epidrual

Question 13

Which has a more pronounced differential block / segmental block?
A spinal or epidural?

Answer 13

Epidural

Question 14

What are the markings on the epidural catheter mean?**

Answer 14

—1 St marking = 5 cm
–Each mark after that is 1 cm
—1st Double mark =10 cm
Thick mark is 11 cm*** at this point you are at the tip of
—Needle in the epidural space
—Triple mark= 15 cm
Single hole at the end vs multiple ports on distal side

Question 15

Is Baricity related to epidural blocks?

Answer 15

NOT related to baricity

Question 16

What are some advantages of CSE

Answer 16

• —CSE anesthesia and analgesia offers the advantages of both spinal and epidural techniques while reducing or eliminating the associated disadvantages (Sort of)
• —Appropriate in all settings in which anesthesia provider plans on doing a spinal or epidural anesthesia
• -Takes advantages of each: quick onset of spinal and flexibility of epidural catheter

Question 17

What is a single-level technique for a CSE?

Answer 17

Needle through needle

Question 18

What is the fail rate of a single level CSE technique?

Answer 18

Fail rate for single level CSE technique 0%-24.5%

Question 19

What is the Volume effect thoery in reference to the increased spinal level after epidural administration for a CSE?

Answer 19

The CSE is know to cause an increased spread of spinal anesthesia after injection of solution through the epidural catheter