Regional Anaesthesia

Question 1

Techniques included in neuraxial anaesthesia

Answer 1

Spinal
Epidural
Caudal epidural

Question 2

General effects of neuraxial anaesthesia on body

Answer 2

Block sympathetic
Sensory analgesia
Motor blockade

Question 3

Absolute indications for spinal or epidural

Answer 3

None

Question 4

Relative Indications for neuraxial blockade

Answer 4

Lower surgery ( abdomen, inguinal , urogénital, Gynae, rectal , lower extremities)

Obstetrics for labour or C section

Post operative pain control

Pain control

Question 5

Absolute ocntraindication for neuraxial blockade

Answer 5

Patient refusal
Bleeding diathesis
Infection At site
Sévère hypovolemia
Elevate ICP

Question 6

Relative contraindication to neuraxial blockade

Answer 6

Sepsis
Uncooperative patient
Severe spinal deformity
Demyelinating lesion

Question 7

Where are needles inserted during spinal and why

Answer 7

Spinal cord ends in most human at L1. 10% extends to L3. Spinal is done below L3

Question 8

Where is LA injected in spinal

Answer 8

In the subarachnoid space directly into CSF

Question 9

Where in epidural and caudal blocks is LA injected

Answer 9

In the epidural space where nerve roots are found unmyelinated

Question 11

Effects of neuraxial blockade on CVD

Answer 11

Decreased BP, HR, cardiac contractility, total peripheral vascular resistance
Venous dilatation

Question 12

Respi effect of neuraxial anaesthesia

Answer 12

Not really affected
Phrenic nerve really hard to block

Question 13

GIT effect of neuraxial blockade

Answer 13

Increased parasympathetic - increased peristalsis, nausea and vomiting

Question 14

Thermorégulation effect of neuraxial blockade

Answer 14

Hypothermia

Question 15

Can you sedate before spinal or epidural

Answer 15

Midazolam may be used at low doses

Question 16

Drugs used commonly for spinal anaesthesia

Answer 16

Heavy bupivacaine
Procaine
Lidocaine
Tetracaine
Ropivacaine

Question 17

Why can we add epinephrine to spinal anaesthesia

Answer 17

To increase duration of action by causig vasoconstriction decreasing rate of absorption

Question 18

Complications of spinal

Answer 18

Transient neurologic syndrome 2-7 days duration after
Backache following SA
Spinal haematoma
Bloody tap
High spinal - Apnoea
Nausea vomiting
Hypotension
Infection

Question 20

D’osage of bupivacaine used in epidural

Answer 20

1ml/kg of 0.25% bupivacaine

Question 21

Complications of epidural blockade

Answer 21

Intravascular injection - altered mental status, LOC, CVD collapse
Lipid emulsion
Duran puncture
Bloody tap
Issue with catheter
Epidural abscess or haematoma