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
Does an epidural work inside out or outside in?
outside in
For epidurals, where is the majority absorbed?
in the circ sys
