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

Choosing the option between fibula plate and nail

Fibula is the secondary bone of our leg which connects knee to ankle along aside tibia as a secondary part . It usually broke along aside tibia as an evidence of major accident There is two option to fix it . Firstly we are choosing about fibula nail as a simple procedure . Surgeon needs only a pliers and nail after creating a port according to its position to fix it under the guidance of c arm . If Surgeon go for here need to open the fracture to fix plate on the area . And needs for clam k wire and other nessary things to fix the fracture. Why the options? Surgeon choose the options according to the fracture , if the fracture line goes vertically ways or the both part of fibula resting perfectly and doesn't dislocated from its own position , surgeon goes for nail fixation. If the fracture is not showing properly in x ray and both end of the bone misplaced after the injury or fracture line is going in a curved ways from upper end to other side lower end in a impro

Trolly layout for cervical spine surgery and a view from assistant perspective.

While spine surgery is one of the major critical surgery according to surgical aspect . Patient position Patient will be position at porne ( face down ) provided diathermy plate . C arm would be position like the x-ray tube under the patient/table and not over it. Under couch systems provide better protection from scattered dose . Trolly for surgery Drapping part Swab holding forcep Gauze and small bowl . Firstly use spirit and then after bitadine to properly disinfect the surgical fracture area . Afterthat we use rubber sheet and laterly green sheet to properly cover the area . And use disposable ioban to cover that portion Fix it properly with towel clip and fixing a diathermy cable and and suction pipe for further loss blood suction. Surgical part We need kidney tray to provide B.P handle(4) and proper size blade (24 ) Austriotam and retractor ( lagenback small blade ) or self retaning retractor according to doctors need. And a mop to Swab blood and and artery

Patient shifting from operation theatre to post operative care unit (Part 1 )

T he safe care of transporting patients to the operating room and recognizing the possible hazards, in order to prevent injuries to the patient and surgery department personnel. The recommended practices aid in ensuring the transfer and transportation of the patient without tissue injury; avoiding undue physical or emotional discomfort. Standard of Practice I It is the responsibility of the HCWs to ensure the safe patient transfer of a patient from a bed to a transportation device. The specific needs of the patient should be considered when selecting the method of transport. This includes: A. Need for IV pole(s) B. Need to transport oxygen tank C. Mobility of the patient D. Conscious, semi-conscious or unconscious patient E. Size of patient F. Age of patient G. Determining the physical abilities and state of health of the patient. Knowing the patient’s state of health and abilities will help in the choice of mode of transportation, decrease the possibility of accidents to th

Operation Theatre & Anesthesia Technology

Search This Blog