Spinal and epidural part II Flashcards
Incidence of PDPH appears to be related to?
size of needle and maybe type of needle
What avoid tracking of skin in to SA space?
stylet
What is the cut and injection of Quinke point?
standard cutting, end injection
What is the cut and injection of Sprotte needle?
rounded point, side injection
What’s the point and injection of Whitacre?
pencil port, side injection
Needle size for spinal/epidural?
22-27
Smaller needles may require?
introducer needle
How do you want to turn towards the dural fibers?
parallel
What do blunt needles do when entering dura?
pop
2 advantages of blunt needles?
less coring, decreased incidence of PDPH
After inserting needle you check for CSF where?
in all 4 quadrants
When you aspirate, what do you look for?
swirl
A block at what level will produce loss of perception of intercostal and abdominal wall muscle movement-dyspnea?
T2-T4
Landmark to block the inguinal ligament?
T12-L1
Landmark for umbilicus?
T10
What do you need to be prepared for for block from C8-T2?
support resp and circulatory
What is it called when medication injected rapidly creates vortex effect and spreads more cephalad?
barbotage
This is defined as the resting position of 2 fluids with different specific gravities when mixed in the same container?
baracity
Specific gravity of CSF?
1.004-1.009
Why is baricity not an issue in the epidural space?
there is no liquid interface
Epidural space is mostly?
fat
How is epidural anesthesia different from SAB?
slower onset and not as dense
Epidural anesthesia is variable based on what 4 things?
drug, dosage, level of injection, concentration
How do you get a walking labor epidural?
sensory block w/out motor block; dilute LA with opioid