Exam 1 Numbers Flashcards
Absolute Contraindications for Spinal Anesthesia:
INR
Platelets
INR > 1.5
Platelets < 100,000
How many total vertebrae do we have? Spinal nerves?
33 - Vertebrae
31 - Spinal nerves
High and low points in the supine position?
High - C3 and L3
Low - T6 and S2
End of spinal cord for adults? Pediatrics?
Adults - L1
Peds - L3
Where does the anterior spinal artery originate? Posterior spinal arteries?
Anterior - Vertebral artery
Posterior - Inferior cerebellar artery
CSF in adults?
100-160 mL
Spinal Lidocaine (5% in 7.5% Dextrose)
Dose to T10
Dose to T4
Duration
Dose to T10: 50-60 mg
Dose to T4: 75-100 mg
Duration: 60 mins, 75-100 mins with Epi
Spinal Tetracaine (1% in 5% Dextrose)
Dose to T10
Dose to T4
Duration
Dose to T10: 6-8 mg
Dose to T4: 10-16 mg
Duration: 70-90 mins, 100-150 with Epi
Spinal Bupivacaine (0.75% in 8.5% Dextrose)
Dose to T10
Dose to T4
Duration
Dose to T10: 8-10 mg
Dose to T4: 12-20 mg
Duration: 90-120 mins, 100-150 mins with Epi
Spinal Ropivacaine (0.5% in Dextrose)
Dose to T10
Dose to T4
Duration
Dose to T10: 12-18 mg
Dose to T4: 18-25 mg
Duration: 80-110 mins
Spinal Levobupivacaine
Dose to T10
Dose to T4
Duration
Dose to T10: 8-10 mg
Dose to T4: 12-20 mg
Duration: 90-120, 100-150 mins with Epi
Epidural Opioid Dosing
Morphine
Fentanyl
Sufentanil
Morphine = 3-5 mg (24 hour duration)
Fentanyl = 50-100 mcg
Sufentanil = 10-25 mcg
Spinal Opioid Dosing
Morphine
Fentanyl
Sufentanil
Morphine = 100-400 mcg (24 hour duration)
Fentanyl = 10-25 mcg
Sufentanil = 2.5-10 mcg
Neuraxial related pruritis treatment?
Benadryl - 25-50 mg
Naloxone 0.1 mg
Buprenex
Neuraxial related pruritis prophylaxis?
Morphine < 300 mcg
Ondansetron 4 mg
Nubain 2.5-5 mg
Epi/Neo wash dosing?
Epi - 0.2-0.3 mcg
Neo 2-5 mg
Spinal additive dosing:
Clonidine
Dexmedetomidine
Clonidine - 15-45 mcg
Dexmedetomidine - 3 mcg
Clinical progression of differential blockade?
B-fibers (Sympathetic)
C and A-delta fibers (Loss of pain/temp)
A-gamma (Loss of motor tone)
A-beta (Loss of touch of pressure)
A-alpha (Loss of motor function/proprioception)
Dosing of hyperbaric SAB in non-OB patient…
Sacral level
T10
T4
Sacral - 1 ml
T10 - 1.5 ml
T4 - 2 ml
Intralipid bolus dose? Infusion?
20% 1.5 ml/kg bolus
infusion = 0.25 ml/kg
Epidural anesthesia dosing?
1-2 mL per segment
2-Chloroprocaine
Concentration:
Onset:
Duration:
Duration w/ Epi:
Concentration: 3%
Onset: 10-15 mins
Duration: 45-60 mins
Duration w/ Epi: 60-90 mins
Epidural Lidocaine
Concentration:
Onset:
Duration:
Duration w/ Epi:
Concentration: 2%
Onset: 15 mins
Duration: 80-120 mins
Duration w/ Epi: 120-180 mins
Epidural Mepivacaine
Concentration:
Onset:
Duration:
Duration w/ Epi:
Concentration: 2%
Onset: 15 mins
Duration: 90-140 mins
Duration w/ Epi: 140-200 mins
Epidural Bupivacaine
Concentration:
Onset:
Duration:
Duration w/ Epi:
Concentration: 0.5-0.75%
Onset: 20 mins
Duration: 165-225 mins
Duration w/ Epi: 180-240 mins
Epidural Ropivacaine
Concentration:
Onset:
Duration:
Duration w/ Epi:
Concentration: 0.75%-1%
Onset:15-20 mins
Duration: 140-180 mins
Duration w/ Epi:150-200 mins
Systolic Pressure Variation
Normal:
Up:
Down:
Normal: 7-10 mmHg
Up: 2-4 mmHg
Down: 5-6 mmHg
Normal Pulse Pressure Variation
13-17%
> 17% give fluids
Normal stroke volume variation
10-13%
< 13% give fluids
EEG waves:
Beta: > 13 Hz
Alpha: 8-13 Hz
Theta: 4-7 Hz
Delta: < 4 hz