Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anaesthesiology > Spinal/caudal > Flashcards

Spinal/caudal Flashcards

1
Q

What are the indications for doing a spinal anaesthetic?

A
  1. C-sections
  2. Surgeries that are less than 2 hours
  3. Surgeries that involve anything below T10
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 layers of the posterior back?

A
  1. supraspinal ligament
  2. interspinous ligament
  3. ligamentum flavum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the difference between a spinal and epidural?

A

An epidural can occur anywhere along the spinal cord and goes into the epidural space which is a potential space. Epidural takes longer to work(30 minutes)
A spinal goes into the sub-arachnoid space and has CSF. It also works faster(usually between 2-3 minutes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which level do we do the spinal?

A

L3/L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the factors that affect the spread of the drug?

A
  1. Baricity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is baricity?

A

It is the density of a substance when compared to human CSF fluid example. dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the movements/positions we can lay the patient in in order to facilitate movement of the spinal?

A
  1. Thoracic block- we must immediately lay the patient down

2. Sacral plexus block-let the patient sit up for 5 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name 6 absolute contraindications for doing a spinal on a patient:

A

1, When a patient refuses

  1. When you have inadequate equipment/ not able to change to GA
  2. clotting disorders which can cause a epidural or spinal haematoma which can cause paralysis in 6 hours if not detected
    - make sure INR>1,5
    - Platelets<75
    - Urea>25
  3. local or systemic sepsis
  4. Active neurological pathology-increased ICP
  5. Cardiac abnormalities: pericarditis, asystoles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are post-operative complications of a spinal?

A
  1. Urinary retention
  2. Meningitis/neural damage
  3. Post Dural puncture headache(2-7 days after) when you have too much CSF leak
  4. Spinal/epidural abscess/ haematoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the conservative Rx for post dural puncture headache?

A
  1. Bedrest
  2. IV fluids
  3. Analgesia
  4. Caffeine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the definitive treatment for post dural puncture headache?

A
  1. Blood patch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do we reduce the incidence of post dural puncture headache?

A
  1. Using the thinnest needle(25/26G) pencil point instead of cutting needle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is urea important?

A

A deranged urea causes platelet dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the acute/intra-op complications:

A
  1. failed spinal from obese patient
  2. high spinal(T1-T4))
  3. Total spinal
  4. Hypotension
  5. bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the management of infection as a complication?

A
  1. antibiotics and surgical decompression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management of a spinal haematoma as a complication?

A
  1. Decompression within 6/8 hours
17
Q

What is the management of a high spinal?

A

Do ABC’s

18
Q

What is NB about caudals and lignocaine?

A

It is neurotoxic

19
Q

What are the relative contra-indications?

A
  • disease of the spinal column that makes inserting the needle difficult
  • severe headaches
20
Q

What does the level and extent of the spinal depend upon?

A
  1. The concentration of the solution injected
  2. The volume of the solution
  3. Position of the patient
  4. Speed and force that we inject the solution with
21
Q

What can we do to decrease the effects of the spinal?

A
  1. Preload the patient with fluids(crystalloids or colloids)
  2. Elevate the legs to improve venous drainage
  3. Use phenylephrine -an intravenous alpha adrenergic agonist
  4. Atropine and glycopyrrolate to cancel the parasympathetic effects and stabilize the heart
22
Q

What size needles do we usually use for spinal?

A

25-30 gauge needles

23
Q

With PDPH, what makes the headache better?

A

-lying down as standing can worsen it

24
Q

What are signs of urinary retention associated with spinal blocks?

A
  • increased heart rate
  • increased blood pressure
  • pressure or pain below the waist
25
Q

What should you do if a total spinal block occurs?

A
  • start cpr
  • give phenylephrine or adrenaline
  • give intravascular fluids
  • endotracheal intubation and mechanical ventilation
26
Q

What takes longer to work between an epidural anaesthesia and spinal?

A

Epidural

27
Q

Which space is an epidural injected?

A

-extradural space

28
Q

Which procedures do we do caudal blocks in usually?

A

-circumcision, cystoscopy, removal of haemmorhoids

29
Q

Where is the epidural anaesthesia usually injected?

A

-ligamentum flavum and the dura mater

30
Q

Where is the epidural anaesthesia usually injected?

A

-ligamentum flavum and the dura mater

Anaesthesiology (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions