Spinal Anesthesia

Spinal Anesthesia is also called spinal block, subarachnoid block, intradural block and intrathecal block, is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm long

fine needle.

Why we choose spinal anesthesia for patient ?

spinal anesthesia is commonly used technique in combination with sedation and genaral anesthesia .

spinal anesthesia is the most common technique widely , combination of sedation and general anesthesia , used below the umbilities ,

Orthopaedic surgery on the pelvis, hip, femur, knee, tibia, and ankle including arthroplasty and joint replacement
Vascular surgery on the leg
Endovascular aortic aneurysm repair
Hernia (inguinal or epigastric)
Haemorrhoidectomy
Nephrectomy and cystectomy in combination with general anaesthesia
Transurethral resection of the prostate and transurethral resection of bladder tumours
Hysterectomy in different techniques used
Caesarean sections
Pain management during vaginal birth and delivery
Urology cases
Examinations under anaesthesia

Anatomy

In spinal anesthesia, the needle is placed past the dura mater in subarachnoid space and between lumbar vertebrae. In order to reach this space, the needle must pierce through several layers of tissue and ligaments which include the supraspinous ligament, interspinous ligament, and ligamentum flavum In order to reach this space, the needle must pierce through several layers of tissue and ligaments which include the supraspinous ligament, interspinous ligament, and ligamentum flavum

Positioning

Patient positioning is essential to the success of the procedure and can affect how the anesthetic spreads following administration. There are 3 different positions which are used: sitting, lateral decubitus, and prone .

#BUPIVACAIN is the drug used in this anesthesia most commonly , some times opioieds also used to improve the quality of the drug .

Contradiction

Patient refusal

Local infection or sepsis at the site of injection

thrombocytopaenia, or systemic anticoagulation
Severe aortic stenosis
Increased intracranial pressure
Space occupying lesions of the brain
Anatomical disorders of the spine
Hypovolaemia e.g. following massive haemorrhage, including in obstetric patients
Allergy

Comments

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