Regional Anesthsia Flashcards
What is regional anesthesia
A type of local anesthesia
*spinal
*epidural
*peripheral nerve block
What are the advantages of regional anesthesia
- Favorably modifies the stress response
- Patients remain awake
- EBL, DVT, cardiopulmonary complications less
- Post-op recovery improved
What is the difference between an epidural and spinal anaesthesia
Epi-not entering the spinal space
Spinal - in subacronoid space
*at L4/L5
What is spinal anesthesia
- Enters the subarachnoid space
- Used no more than 2 hours
- Post-spinal headache can occur form CSF leak
What is an epidural
- Enters space between Ligamentum flavin and dural structures
*above the dura, no CSF - Requires larger volumes of anesthesia
- Onset is slower than spinal
- No potential for spinal headache
What can be a complication of an epidural
Potential for misplacement
1. Entry into subarachnoid space an result in total spine block or a high block with cardiovascular collapse
What can spinal and epidural blocks cause
Prolonged blockade of parasympathic bladder innervation
*can cause urinary retention, need for catheter
What is a peripheral nerve block (regional nerve blockade)
- Any deliberate interruption of single traveling along a nerve, often for the purpose of pain relief
What is a local anesthetic nerve block?
- Short-term block usually lasting hours or days
- Involves injecting anesthetic onto or near a nerve
- Ultrasound guidance may be utilized
How is the femoral triangle set up
NAVEL
Nerve
Artery
Vein
Empty space
Lymphatics
(Pectineus muscle after that)
What are the contraindications of regional anesthesia
- Infection at injection site
- Uncorrected hypovolemia
- Untreated coagulation defects
- Increased ICP
What are the complications of regional anesthesia
- Total spinal block
- Post dural puncture headache (PDPH)
- Neurological injury
- Anesthetic toxicity
- Failure / inability to deliver anesthesia
