Spinal Anesthesia

Question 1

Spinal cord level

Answer 1

L1

Question 2

Risk factors for PDH

Answer 2

Young
Pregnant
Female
Non pencil point
Needles size

1%-11%.

Question 3

Cutting-edge needles

Answer 3

Quincke
Pitkin
Atracan

Question 4

Risk factors for PDH

Answer 4

Age <40
Air travel
BMI<30 
History of PDH
Cutting needles 
Large bore

After spinal puncture 1-11%

The incidence of accidental puncture with an epidural needle is around 1.5%, with a 52% chance of developing PDPH.

PDPH typically occurs within the first 24-48

can last up to a week

Question 5

TURP

Answer 5

Glycine = temporarily blindness ( inhibitori neurotransmitter)

Metabolized to ammonia =hyperammonemia can cause encephalopathy nausea and vomiting tto wt arginine = promotes urea formation from ammonia

CV HTN bradycardia pulmonary edema EKG wide QRS elevated ST segments ventricular arrhythmias

Tachypnea desaturation cheyne stokes
Renal failure
Henolysis

HYPONATREMIA**

Distilled water : hemolysis dilutional hyponatremia

Normal saline: ions cause electric dispersion

Sorbitol : manitol not electrical dispersion but hyperglycemia osmotic diuresis volume expantion ( CHF)