Spinal anesthesia 6/5 Flashcards
what do you need for monitoring during intrathecal anesthesia
- BP, pulse-ox, EKG (if you have time)
- O2 optional
What is the bolus dose of intralipid for systemic LA toxicity ? gtt ?
- bolus: 1.5 mL/kg of 20% intralipid
- gtt: 0.25 mL/kg/min
What drug is commonly associated w/ allergies?
Rocuronium
What LA class is associated with allergic reaction
Esters (PABA derivative)
What is the dermatome level for the scrotum?
S3
What is the dermatome level for the penis?
S2
What is the dermatome level for the testicles
T8
Upper abdominal surgery requires a block to what dermatome level?
T4
Peri-anal / anal surgery needs a sensory block at
S2-S5
Foot/ankle surgery requires a block at what dermatome level?
L2
A sensory block at L1 is great for what procedures?
thigh/knee/lower leg
Lower abdominal/urologic / gynecologic procedures **(not open c-section) **require a block at what dermatome level
T6
Vaginal delivery, uterine, hip and TURP require a block at what dermatome level?
T10
List some benefits of using pencil-point (non-cutting) needles for SAB
- less drag of contamininants
- click/pop can be sensed
- less risk of PDPH (less than 1% risk of PDPH and failure rate of only 5%)
List examples of pencil-point needles
- sprotte
- whitacre
- pencan
- Greene
- Gertie Marx
Dr.Sprotte uses a Whitacre because a PenCan help Mr. Green have spinal anesthesia with less painful Marx
Examples of cutting needles:
Cutting with a Pitkin is a Quinke way to reach the subarachnoid space
List the layers you will traverse when accessing the subarachnoid space
- skin
- subq
- supraspinous ligament
- interspinous ligament
- ligamentum flavum
- dura mater
- subdural space
- arachnoid mater
- subarachnoid space
What ligament is the needle stabilized in
interspinous ligament
Accessing subarachnoid space
What do you feel once you pass through the dura?
Pop
spinal needle will be inserted further with a lateral or midline approach
further with paramedian (lateral)
