Week 11 Spinal and Epidural Flashcards
When was the first spinal done and with what drug?
- 1885 to 1890
- Cocaine
What would your assessment of the patient be before a spinal or epidural?
- History
- Medication
- Surgical History
- INFORMED CONSENT
What equipment would be needed for resuscitation of a epidural or spinal patient?
- Monitor
- IV
- Midication
- O2
- Sedation
How would you place a cutting spinal/epidural needle?
-Longitudinal
What would happen if dermal cells were introduced epidural space or sub-arachnoid space?
Dermoid spinal cord tumor
What are absolute contraindications for a spinal or epidural?
- PATIENT REFUSAL
- Lack of cooperation
- Uncorrected coagulopathies
- Infection
What effects the uptake and spread of a spinal?
- Concentration of LA in CSF
- Surface area of nerve tissue exposed
- Lipid content of nerve tissue
- Blood flow to nerve tissue
What effect the distribution of a spinal?
- Baricity
- Position
- Dose
What are hypObaric drugs for a spinal?
- Tetracaine
- Lidocaine
What are isbaric drugs for a spinal?
- Tetracaine
- Lidocaine
- Bupivacaine
What are the hyperbaric drugs for a spinal?
- Tetracaine
- Lidocaine
- Bupivicaine
- Bupivicaine
DEXTROSE is usually used for the mixture
T/F: If MAP is unchanged to the liver the liver will have no changes.
TRUE
What would be a sign of a high spinal?
-Dyspnea
At what level would you see the GI affected by a spinal?
T6 to L2
What would be the S/S of a sympathetic innervation to the GI?
- Increased secreation
- Sphincters relax
- Bowel constricts
What would you use to treat for N/V of a high spinal?
-Atropine
What local anesthetic is currently not approved by the FDA for a spinal?
2-Chloroprocaine
List the onset, duration, and Dose of Lidocaine?
- 3 to 5 minutes
- 60 to 90 minutes
- 25 to 50 (25 to 100)
List the onset, duration, and dose of Tetracaine?
- 3 to 6 minute
- 70 to 180 minutes
- 5 to 20 mg
List the onset, duration, and dose of bupicicaine?
- 5 to 8 minutes
- 90 to 150 minutes
- 5 to 20 mg
What is the segment of the back at the iliac crest?
-L4 to L5
Where would you feel the pop when placeing the spinal?
-Dura
How fast should solute be injected into the spinal?
0.5 mL/sec
When would you use a paramedian approach?
-Calcified intraspinous ligament
