Spinal Injection
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How are you All? Hope everyone doing well. I am medical student of Bs Operation Theater Technology. I decided to worte a daily Blog with all of you which i seen in operation theater today i am Here to share the Spianl Anesthesia.
Spinal Anaesthesia refers to segmental anaesthesia where an anaesthetic agent is injected in the CSF in the subarachnoid space within the lower back area. It is mostly used in laparotomy, perineal and the lower limb procedures and any operation that needs the surgeon to reach the pelvic gasket.
Procedure
• Preparation:
Obtain informed consent.
The patient is positioned—or as a rule sits or lies on one side with the legs drawn up to the abdomen.
To demonstrate that the site is sterile sterility is maintained by washing the site then application of an aseptic method in the draping.
• Injection:
The vertebral body is reached with aspirating a spinal needle in the interspace between the vertebrae usually L3-L4 or L4-L5.
Normally, the check follows to confirm that the needle is in the subarachnoid space, for instance, by visualizing free flow of CSF before administering the anesthetic.
• Onset:
Surgery: The anesthetic action begins few minutes (5-10 min) after administration.
Sensory and motor block is below the level of injection site..
Commonly Used Drugs
Local Anesthetics: Local anesthetics include – Bupivacaine, Lidocaine, Ropivacaine.
Adjuvants: With children PNB can be extended with using opioids as fentanyl or morphine, and vasoconstrictors with epinephrine.
Advantages
Rapid onset.
Reduction of the morbidity and mortality related to the complications of episodic use of general anesthesia.
Reduced levels of blood loss and better control over high blood pressure.
Suitable for high risk patient with systemic diseases.
Complications
• Immediate:
Hypotension.
Bradycardia.
Nausea and vomiting.
• Post-procedure:
Ex- Spinal headache or more formally known post-dural puncture headache (PDPH).
Backache.
Neurological side effects are few but none can deny that carcinogens cause neurological outcomes.
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