Locals/Regional Anesthesia 2 Flashcards
Does a spinal work inside out or outside in?
Inside out
______: LA spreads to the _____ of the cauda equina to the nerve roots
SPINALS: LA spreads to the NERVES of the cauda equina to the nerve roots
What 2 factors determine the duration of spinal anesthesia?
- dose of the LA
- Vasoconstrictor used
What are 2 drug factors which affect LA distribution and block height?
Dose
Baricity (density of LA to CSF)
What are 3 patient factors which affect LA distribution and block height?
CSF volume
Advanced age
Pregnancy
What are 2 procedural factors which affect LA distribution and block height?
Patient position
Epidural injection post spinal
What are the 3 types of LA baricity?
Hypobaric
Isobaric
Hyperbaric
Which type of baricity occurs when LA is mixed w/sterile h2o/warmed and flows up in the CSF columns: Hyperbaric, Hypobaric, Isobaric?
Hypobaric (goes up)
Which type of baricity occurs when LA density = CSF density and stays at about the same spot in the CSF column: Hyperbaric, Hypobaric, Isobaric?
Isobaric (stays where it is placed)
Which type of baricity occurs when LA is mixed with dextrose and flows to most dependent part of the CSF column due to gravity: Hyperbaric, Hypobaric, Isobaric?
Hyperbaric (goes where gravity takes it)
What is the earliest complication?
HYPOTENSION
At what block heights do we see hypotension?
T1-4
T5-L2/3
What are the early complications of spinal anesthesia?
Hypotension
paresthesia
bloody tap
respiratoy (dyspnea & apnea)
N/V
What are the later complications of spinal anesthesia?
Backache
urinary retention
Post dural puncture headache
Neurologic impairment/injury
Infection
Severe complications (arrest)
What is the most common latest complication?
BACKACHE
