Other Types Of Anaesthesia Flashcards
List 4 other types of anaesthesia other than GA
Peripheral nerve block
Central neuraxial anaesthesia/spinal block
Epidural anaesthesia
Local anaesthesia
Outline peripheral nerve blocks
- type of regional anaesthesia
- patient remains awake
- local anaesthetic is injected around specific nerves under US guidance > distal areas are anaesthetised
Outline central neuraxial anaesthesia
- also called spinal anaesthetic or spinal block
- type of regional anaesthesia
- local anaesthetic is injected into CSF within subarachnoid space
- in the lumbar spine after the spinal cord ens
- L3/4 or L4/5
- causes numbness + paralysis of areas innervated by spinal nerves below the injection
- lasts 1-3 hours
Where is the needle normally inserted in spinal block anaesthesia?
L3/4 or L4/5
When is a spinal block most commonly used?
- C sections
- transurethral resection of prostate
- hip fracture repairs
Outline epidural anaesthesia
- catheter inserted into epidural space in lower back
- local anaesthesia put into epidural space
When is epidural anaesthesia most commonly used?
During labour
Post op after open abdominal surgery
What drug is most commonly used in epidurals
levobupivacaine
+/- fentanyl
Adverse affects of epidurals
- headache if dura if punctured
- hypotension
- motor weakness in legs
- nerve damage
- infection e.g. meningitis
- haematoma > spinal cord compression
What are the risks of using epidural during labour?
- prolonged second stage
- increased probability of instrumental delivery
Examples of local anaesthesia
Lidocaine
Lignocaine
Bupivacaine
What type of local anaesthesia is more likely to cause an allergic reaction
Ester groups e.g.chloroprocaine
What is minimum alveolar concentration?
[Alveolar] at 1atm that prevents purposeful movement in response to surgical stimulus in 50% of patients
What affects MAC?
Does it increase it or decrease it?
increases:
- infants
- hyperthermia
- pregnancy
- alcoholism
- central stimulants
.
decreases:
- eldery
- hypothermia
- sedatives
- opioids
Relationship between gauge and flow
increasing gauge decreases the diameter/volume
Relationship between French gauge and flow
Increasing gauge, increases the diameter/flow
e.g. in catheters
What agent can be given to treat local anaesthetic toxicity?
IV 20% lipid emulsion
