ANATOMY OF SPINAL CORD
SPINAL ANESTHESIA
ANAESTHETICS USED
HYPERBARIC (HEAVY)
LIGNOCAINE 5% IN 7.5%DEXTROSE
BUPIVACAINE 0.5% IN 5% DEXTROSE
HOW A HEAVY ANAESTHETIC
SOLUTION FLOWS IN CSF
INDICATIONS
Fit patient requiring lower abdominal, anal of lower
extremity surgery
A patient having relative contraindication to general
anaesthesia eg respiratory infection, asthma, or a
deformed airway
Operations where the patient needs to be placed prone eg
excision pilonidal sinus
Operations of one lower extremity ( hemispinal)
CONTRAINDICATIONS
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Unco-operative patient
Operations lasting more than 2 hours
Hypovolemic shock
Children
Sepsis anywhere on the back
Operations on the thorax and above
TECHNIQUE
• Preload with 500- 1000ml crystalloid
• Premedicate – pentazocine,prometazine,
atropine
• Moniter BP,pulse and O2 sat, heart rhythm
COMPLICATIONS
IMMEDIATE
Hypotension- increase IV fluids, use small doses of vasoconstrictors eg
mephenteramine ( 3mg iv as needed)
Bradycardia- iv atropine
Respiratory distress- supplement with O2, bag and mask or intubate
Inadequate block – supplement with IV ketamine
Total spinal
LATE
Headache
Meningitis
Back pain