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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

 

 

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