complications of spinal anaesthesia ppt

Bupivacaine and ropivacaine will have an onset of 20-30 minutes, an anesthetic duration of 8-10 hours, and provide analgesia for 16-18 hours. • Antiseptic painting: The abdomen is painted with 7.5% povidone-iodine solution or savlon lotion and to be properly draped with sterile towels. • Subarachnoid space - between spinal cord and the dura • extends from the foramen magnum to the sacral hiatus & contains CSFhiatus & contains CSF • administration of local anesthetic or opioid - rapid onset of analgesia/anesthesia - limited duration • ***Medications are 10-20 times more potent than in epidural space 1. This review of the literature will focus on positioning, airway management, spinal deformities, pulmonary me - ASA 2 A patient with mild systemic disease e.g., mild asthma or well controlled hypertension. Anesthesia-Related Factors • Anesthesia time > 3 hours is an independent risk for postoperative pulmonary complications • GENERAL ANESTHESIA • Can worsen post operative hypoxemia with residual NMB • Suppresses cough and gag reflex leading to aspiration • Exposure to anesthetic can change gas exchange and Untreated, severe hypertension can lead to serious post operative complications for example myocardial infarction, cerebral haemorrhage, infarction and renal failure. August Bier 1885. Give antiemetics to prevent/treat postoperative nausea and vomiting. Ans:b. The mother is able to remain awake and participate fully in the birthing experience, thus facilitating earlier bonding . Breast Cancer ppt. The anesthetic agent is . Methods: In terms of these patients' anesthetic management, it is essential to consider some details: (1) effective, safe perioperative management by a multidisciplinary approach, and quick, good communication among clinical specialists to achieve correct patient management; (2) neuroaxial block, particularly spinal anesthesia, is the first . In conclusion, major complications after neuraxial techniques are rare but can be devastating to the patient and the anesthesiologist. COMPLICATIONS OF SPINAL & EPIDURAL ANAESTHESIA NUR HANISAH ZAINOREN. Prevention and management begin during the preoperative visit with a careful evaluation of the patient's medical history and appropriate preoperative discussion of the risks and benefits of the available anesthetic techniques. Dr.M.Kannan MD DA Professor And HOD Department of Anaesthesiology Tirunelveli Medical College Spinal Anaesthesia * * * * * * Indication Economical Pulmonary Diseases Full Stomach Lower Abdominal Surgery Ischemic Heart Diseases for Lower Abdominal Surgery Relative Contraindication Hypotensive Patients Cardiac failure Raised ICT Spinal Deformity Refusing Patients Bleeding Diathesis Skin . A spinal block is a type of local anesthesia that is administered into the fluid of the spinal column. Anesthesia in Preeclampsia General anesthesia is a well-known hazard in obstetric anesthesia: 16X more likely to result in anestheticrelated maternal mortality Mostly due to airway/respiratory complications, which would only be exaggerated in preeclampsia Hawkins, Anesthesiology 1997;86:273 Platelets & Regional Anesthesia A form of regional anaesthesia involving injection of local anaesthetic into the SA space through a fine needle objectives Describe anatomy of spinal canal Identify anatomic landmarks for proper placement of a spinal needle Define appropriate steps for placement of spinal . Also called spinal block or subarachnoid block 2. Anesthesia for Spine Surgery Sherif . Neuraxial Anesthesia • Neuraxial anesthesia is a type of regional anesthesia that involves injection of anesthetic medication in the fatty tissue that surround the nerve roots as they exist the spine (also known as an epidural and caudal) or into the cerebrospinal fluid which surrounds the spinal . 44.An increased dose of spinal anesthetic is indicated in a patient who has a) Ascites b) Increased height of the patient c) Is pregnant d) Obese. Introduction Caudal anaesthesia has been used for many years and is the easiest and safest approach to the epidural space. Discuss with the patient options for anesthesia. Fortunately, severe or disabling neurologic complications rarely occur. Anatomy ppt. This symposium will highlight recommendations for the management of common complications of anesthesia, such as postoperative 2. Management of total spinal block in obstetrics Shiny Sivanandan* and Anoop Surendran *Correspondence email: sivanandanshiny@yahoo.com doi: 10.1029/WFSA-D-18-00034 INTRODUCTION Total spinal or a high neuraxial blockade is a recognised complication of central neuraxial techniques that include spinal and epidural anaesthesia. Persons: Twenty-one anaesthesiologists and anaesthetist nurses covering ten African countries. In medical history, few complications have come to be associated as closely to a specific technique as PDPH with spinal anesthesia. It has about the same JR Hebel, TT Horlocker, DR Schroeder. HISTORY • Corning accidentally administered cocaine intrathecally in 1885 • The first spinal anaesthesia in humans was given by Beir from Germany in 1898 using 0.5% cocaine. Antibiotics ppt. It is important to think ahead. Spinal anaesthesia reduces perioperative risk in total knee replacement surgery . Explain risk and benefits. Patients with conditions who are . Winner of the Standing Ovation Award for "Best PowerPoint Templates" from Presentations Magazine. Fortunately, severe or disabling neurologic complications rarely occur. Recognition of potential complications of the disorder is vitally important for the anesthesia provider as well as for all staff involved in the continuum of care of patients with osteogenesis imperfecta. Pain control: consider epidural or patient controlled analgesia (PCA) with opiates as well as other non-opiate adjuncts. Recent clinical studies have answered major pharmacodynamic and pharmacokinetic questions, thus providing the scientific background for safe and effective blocks in daily clinical practice and demonstrating that patient selection can be expanded to range from extreme preterm births . Hypotension after spinal anesthesia is a physiological consequence of sympathetic blockade. Spinal anaesthesia. All patients had either neuraxial anesthesia or analgesia. International Journal Obstetric Anaesthesia 2005, Vol 14 pages 53 - 57. The spectrum of spinal surgery in adult life is considerable. Dr S R Nafeesa Banu Spinal anaesthesia-defn 1. at risk of suboptimal recovery, such as those recovering from stroke, myocardial infarction or perinatal complications. Explain risk and benefits. The diagnoses and management of these sequelae are discussed … It has been increasingly recognized over the past few decades. Methods: Two anonymous questionnaires; the first, filled in each anaesthetic problem occurred, to define the type of incident or . Preoperative assessment. 76 In addition, central neuraxial anesthesia has been show to decrease the hypnotic requirements of midazolam, thiopental, and potent inhaled anesthetics. Spinal anesthesia : is the injection of small amounts of local anaesthetics into the ( CSF ) at the level below ( L2 ) ,where the spinal cord ends , anesthesia of the lower . Whether anesthetic drugs are administered in the hospital setting or in an ambulatory surgery center, pharmacists should be aware of the risks in order to assist in managing anesthesia drug-related complications. There is a relationship between regional anesthesia and patients that receive anticoagulant medications during surgery. If CSF leakage occurs at a rate greater than that of CSF production (0.3 . Perioperative nerve injuries have long been recognized as a complication of spinal and epidural anesthesia. The volume of fluid given will vary with the age of the patient and the extent of the proposed block. HOW A HEAVY ANAESTHETICSOLUTION FLOWS IN CSF . The Journal of Perinatal and Neonatal Nursing, 19(3), 207-209. All patients having spinal anaesthesia must have a large intravenous cannula inserted and be given intravenous fluids immediately before the spinal. Thoracic paravertebral injection of local anesthetic at multiple levels (C7-T6) 11,14,26or as a single injection at T4 72in conjunction with intraoperative sedation is safe and effective for surgical anesthesia in a majority of patients undergoing major breast surgery 11,14,16,25,26,72and is associated with minimal complications 11,26and a . Anaesthesia • Anesthesia—may be spinal, epidural or general STEPS • Position of the patient: dorsal position. Neuraxial anesthesia 1. Dr.M.Kannan MD DA Professor And HOD Department of Anaesthesiology Tirunelveli Medical College Spinal Anaesthesia * * * * * * Indication Economical Pulmonary Diseases Full Stomach Lower Abdominal Surgery Ischemic Heart Diseases for Lower Abdominal Surgery Relative Contraindication Hypotensive Patients Cardiac failure Raised ICT Spinal Deformity Refusing Patients Bleeding Diathesis Skin . anaesthesia Dr. Mumena C.H General complications Complications following anaethesia depends how correctly it was given After injection of local anaesthesia, patient shouldnt be left alone Prophylactic measures should be taken before any complication There 4 groups of general complications General complications 4 groups of general complications are: Psychogenic Toxic . This review of the literature will focus on positioning, airway management, spinal deformities, pulmonary me - Spinal anaesthesia has long been established as the anaesthetic technique of choice for caesarean section because it avoids the risks of general anaesthesia such as failed tracheal intubation, aspiration and unwanted awareness. incidence for spinal anesthesia is 1:220,000. Wanawimol Saengchote M.D. Spinal anesthesia • Advantages: • 1) Full, deep anesthesia with a muscular relaxation; • 2) Absence postoperative pulmonary complications. Cardiovascular . Local Anesthesia has been defined as Loss of sensation in a circumscribed area of the body caused by depression of excitation in nerve endings or inhibition of the conduction process in peripheral nerves. The most common are postdural puncture headache and hypotension. A young, fit man having a hernia repair may only need 500 mls. Postoperative epidural hematoma can result in spinal cord injury. 4. Anesthesia ppt. The technique of administering spinal anesthesia can be described as the "4 P's": preparation, position, projection, and puncture. - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 569420-MjVkZ International Journal Obstetric Anaesthesia 2005, Vol 14 pages 53 - 57. Wilson MJA (2005) When Giving Spinal Anaesthesia for Caesarean Section after the Epidural has Failed the Normal dose of Spinal Anaesthetic should be used. 4. fDefinition. Stenuit J, Marchand P: [Sequelae of spinal anesthesia]. Presented by: Dr.Anurag Giri. • Subarachnoid space - between spinal cord and the dura • extends from the foramen magnum to the sacral hiatus & contains CSFhiatus & contains CSF • administration of local anesthetic or opioid - rapid onset of analgesia/anesthesia - limited duration • ***Medications are 10-20 times more potent than in epidural space 3. Inform the Introduction Congestive cardiac failure (CCF) is a common and debilitating condition. In a study of 658 intracranial and spinal procedures, it was found to have a sensitivity of 79% and a negative predictive value of 96% for detection of neurological injury. In the UK, the Third National Audit Project of the Royal College of Anaesthetists found that permanent injury after CNB caused by spinal haematoma or abscess, but also by meningitis, nerve injury, spinal cord ischaemia, fatal cardiovascular collapse or wrong-route errors, was 1:23 810 cases (4.2 . Patients . Yentis S et al (2001) Analgesia, Anaesthesia and Pregnancy - A Practical Guide Chapter 46, pages 121 - 124. Anaesthesia for major spinal surgery, such as spinal stabilization following trauma or neoplastic disease, or for correction of scoliosis, presents a number of challenges. - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 3c1ce9-YmM3M Atrial fibrillation is poorly tolerated. Anesthetic Management of Abdominal Surgery 57 ASA 1 Healthy patient without organic, biochemical, or psychiatric disease. Winner of the Standing Ovation Award for "Best PowerPoint Templates" from Presentations Magazine. Complications of Flexed Prone Position Brachial plexus . Employing the methods of the early 20th century, spinal anesthesia was frequently followed by severe and prolonged headache, casting a long shadow over the development and acceptance of this modality. Spinal Anaesthesia. When correctly performed there is little danger of either the spinal cord or dura being damaged. Risk factors contributing to neurologic deficit after neuraxial anesthesia include spinal cord ischemia (hypothesized to be related to the use of vasoconstrictors or . Complications The complication rate for interscalene blocks is relatively high. Nerve damage- this is a rare complication of spinal anaesthesia. Objective: To evaluate the risk of the practice of spinal anaesthesia (SA) in African tropics. Combined spinal-epidural and single-shot spinal anaesthesia are both used. World's Best PowerPoint Templates - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. 43.The most common complication in spinal anesthesia is a) Post spinal headache b) Hypotension c) Meningitis d) Arrhythmia. 58 patients received epidural anesthesia and 81 received spinal anesthesia. recovering from surgery. Current Researches in Anesthesia & Analgesia: January 1947 - Volume 26 - Issue 1 - p 30-33. Before this, the only local anesthetic techniques were topical anesthesia . 62 Both i.v. Caesarean section should whenever possible be performed under neuraxial anaesthesia. They'll give your presentations a professional, memorable appearance - the kind of sophisticated look that today's audiences expect. Complications are related to either exaggerated physiologic responses or needle/catheter insertion and include: The development of regional anesthesia started with the isolation of local anesthetics, the first being cocaine (the only naturally occurring local anesthetic). Author Information . COMPLICATIONS O. Purpose: Enhanced recovery after surgery (ERAS) protocols aim to develop peri-operative multidisciplinary programs to shorten length of hospital stay (LOS) and reduce complications, readmissions and costs for patients undergoing major surgery. The American Society of Anesthesiologists (ASA) Closed Claim Project (CCP) report on nerve injuries, first published in 1990 1 and updated in 1999, 2 heightened awareness of PNI. Spinal anesthesia has little effect on ventilation but high spinals can affect abdominal/intercostal muscles and the ability to cough. Spinal anesthesia. The length of surgery and hospital LOS were both decreased in the spinal anesthesia population. al. 223-228. Complications 1. Yentis S et al (2001) Analgesia, Anaesthesia and Pregnancy - A Practical Guide Chapter 46, pages 121 - 124. Symptomatic arrhythmias should be treated, and attempts made to control heart rate to around 80 beats per minute. Local anaesthesia.ppt - The basic advantages of local anesthesia \u2022 1 Safety for the patient \u2022 2 Simplicity of a technique \u2022 3 Cheapness of a . tion of fractures. Postoperative hypotension can result in spinal cord ischemia. Neonatal Anesthesia (Anesthesia Text) Anesthesia-related morbidity and mortality is higher in infants than adults, as well as in younger compared to older children. Minn Med 1943;36:339-345. Early ambulation A high Ans:b. No significant impact on daily activity. Definiton of Epidural anesthesia 9. Retrieved November 19, 2007, from Ovid Technologies Inc, database. Caudal epidural blockade in children is one of the most widely administered techniques of regional anaesthesia. Spinal anesthesia, a form of regional anesthesia involves the injection of certain anesthetic drugs into a fluid-filled space in which the spinal cord and the nerves arising from it are suspended . Temporary loss of sensation, pins and needles and sometimes muscle weakness may last for a few days or even weeks, but most disappear with time and a full recovery is made. Multiple studies have revealed potential mechanisms of perioperative PNI . Facial nerve paralysis 4. This document has been produced to guide the neurological monitoring of obstetric patients who receive neuraxial analgesia or anaesthesia, in order to support earlier detection and minimise harm. Local Complications 1. Results: Spinal anesthesia was performed easily in all 30 patients, although two patients complained of paraesthesiae, which responded to slight needle withdrawal. ANAESTHETICS USEDHYPERBARIC (HEAVY)LIGNOCAINE 5% IN 7.5%DEXTROSEBUPIVACAINE 0.5% IN 5% DEXTROSE. Perioperative nerve injuries have long been recognized as a complication of spinal and epidural anesthesia. Preparation Preparation of equipment/medications is the first step. * McCarthy, K. C. M.D. Brain Circulation ppt. Paediatr Anaesth 11: 711, 2001]. The sympathetic block can exceed motor/sensory by two dermatomes. Perioperative peripheral nerve injury (PNI) is a well-recognized complication. SPINAL ANESTHESIA. It is used to provide peri and post operative analgesia in adults and children. Serious neurological complications after spinal anesthesia are rare, but do occur. 103(1), 2006. The first regional anesthetic technique performed was spinal anesthesia, and the first operation under spinal anesthesia was in 1898 in Germany by August Bier. Combined spinal-epidural has gained some popularity in recent years as intra-operative anaesthesia can be continued postoperatively by giving drugs through the epidural catheter 1. Technique of SPinAL AneSTheSiA indicATion And conTrAindicATion Guided by: Dr. Shubhada Deshmukh (M.D.) When assessing a patient for anaesthesia, ask about related illnesses such as ischaemic heart disease, renal failure and cerebrovascular disease. 3. The goal of the block is to numb the back so the surgeon can operate while the patient is still conscious. Anemia ppt. Spinal anesthesiaisalso called asspinal block or subarachnoid block (sab). Needle breakage 2. The incidence of epidural hematoma formation increases to 33:100,000 for epidural anesthesia and 1:100,000 for spinal anesthesia. and volatile agents affect evoked potential characteristics but propofol causes significantly less suppression at a comparable depth of anaesthesia. BIOLOGY ppt. Wilson Frame Maintains flexed position for spinal surgery Horse . Trismus 5. Keschner M: The effect of injuries and illness on the course of multiple sclerosis. Spinal haematoma following spinal anaesthesia is a severe complication that requires early surgical intervention to prevent permanent neurological damage. Department of Anesthesiology, Ramathibodi Hospital, Mahidol U * * SAFETY Anesthesia Incident Monitoring Study January to June 2007. World's Best PowerPoint Templates - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. Technique 11. Differences between spinal and Epidural Anesthesia. Postoperative epidural hematoma can result in spinal cord injury. Nausea and Vomiting Nausea and vomiting presenting after spinal anesthesia are distressing for the patient and may impede the surgeon. CANDIDIASIS ppt. Serious neurological complications are rare, but early detection is important to reduce or prevent permanent harm. tion of fractures. ANATOMY PHYSIOLOGY ppt. Complications of Spinal Anesthesia. In a 2013 retrospective study, 23 6,030 patients received spinal anesthesia and 8,022 patients received GA. Spinal anesthesia has been shown to have sedative effects in the absence of intravenous sedation. Study design: Prospective study in multiple centres over a two years period. It is important to think ahead. SAB isaregional anesthesiainvolving injection of alocal anesthesiainto thesubarachnoid spacewhich extendsfrom . Recognition of potential complications of the disorder is vitally important for the anesthesia provider as well as for all staff involved in the continuum of care of patients with osteogenesis imperfecta. Risk factors contributing to neurologic deficit after neuraxial anesthesia include spinal cord ischemia (hypothesized to be related to the use of vasoconstrictors or . Permanent nerve damage is rare (approximately 1 in 50,000 spinals). The type of patients who would have been declined surgery 20 yr ago for medical reasons, are now being . 77-79 The proposed mechanism for this independent sedative effect of spinal anesthesia is a . Interestingly, two textbooks on the complications of anaesthesia appear to provide no definition of this term 10, 11, but a third, by Valchanov et al., offers the following, without citing any prior source: 'a complication is an unfavourable evolution of a disease process or its management' 12. Wilson MJA (2005) When Giving Spinal Anaesthesia for Caesarean Section after the Epidural has Failed the Normal dose of Spinal Anaesthetic should be used. Pain control: consider epidural or patient controlled analgesia (PCA) with opiates as well as other non-opiate adjuncts. The patient should be informed of what to expect and potential complications. Regional anesthesia uses local anesthetics to cause a temporary loss of sensation in a particular portion of the body. The technique of administering spinal anesthesia can be described as the "4 P's": preparation, position, projection, and puncture. The postulated mechanism is low cerebrospinal fluid (CSF) pressure from transdural CSF leakage through a needle or catheter-induced dural defect. Back pain ppt. The patients receiving spinal anesthesia had a lower rate of wound infection, blood transfusions, and overall complications. Minor Complications of Spinal Anesthesia. Spinal anesthesia blocks small, unmyelinated sympathetic fibers first, after which it blocks myelinated (sensory and motor) fibers. 2. Soft tissue injury 6. Spinal anaesthesia in pregnancy Decreased dose requirement due to • Mechanical factor : compression of IVC causes shunting of blood to the venous plexus in the vertebral canal- decreased vertebral canal space and CSF volume • Hormonal factor - higher progesterone levels 72. 4. Inform the 45.All are surface anesthetics except a) Lignocaine b . 8. Carcinoma; CARDIOLOGY ppt. Give antiemetics to prevent/treat postoperative nausea and vomiting. Classically, the incidence of this condition has been accepted as 1 in 220, 000 patients undergoing spinal anaesthesia, but the actual incidence remains unknown and is presumed to be on the . Indication contraindication and complications 10. 2. Preparation Preparation of equipment/medications is the first step. Neuraxial Anesthesia Anesthesia department Al azhar university 2016 2. , such as burns, amputations or spinal cord injuries who may develop serious preventable complications. ANAESTHESIA ppt. complications. It is the regional anaesthesia obtained by temporary interruption of nerve transmission of spinal nerves by injecting anaesthetic agents in to the subarachnoid space. Postdural puncture headache (PDPH) is a common complication of spinal anesthesia, with an estimated incidence of less than 3%. Neuraxial anesthesia and analgesia in patients with preexisting central nervous system disorders. Complications of local. Complications of Neuraxial Anesthesia (Spinal/Epidural) In general, there is a low incidence of serious complications related to neuraxial anesthesia, but those that occur may be temporary or permanent. In particular, airway complications are more likely in very young infants. No patient required . Abstract. Types of regional anesthesia include a spinal, epidural, nerve block, and Bier block. Hematoma 7. Spinal anesthesia is usually used for surgery on the lower abdomen, groin area, perineum, or lower extremities. Basics of Anesthesia ppt. There are different locations that the injection can be placed depending on the anesthesiologist preferred method. Early ambulation They'll give your presentations a professional, memorable appearance - the kind of sophisticated look that today's audiences expect. Paresthesia 3. Incidence of intraoperative nausea and vomiting (IONV) in nonobstetric surgery can be up to 42% and may be as high as 80% in parturients. Anesthesia & Analgesia. . Unlikely to have an impact on anesthesia and surgery. 200,000 . Res Publ Assoc Res Nerv Ment Dis 1950;28:533-547. Blood Transfusion ppt. Toledo, Ohio *Presented as part of a Panel Discussion on Spinal Anesthesia before a meeting of the Ohio Society of Anesthetists, Columbus, Ohio, May S, 1946. Not only is the incidence of severe complications of importance, but also ultimate patient outcome. Acute Renal Failure ppt. Our new CrystalGraphics Chart and Diagram Slides for PowerPoint is a collection of over 1000 impressively designed data-driven chart and editable diagram s guaranteed to impress any audience. INDICATIONSEconomicalPulmonary DiseasesFull StomachLower Abdominal SurgeryIschemic Heart Diseases for Lower Abdominal Surgery Cerebral Circulation ppt. Ropivacaine is a safer alternative to bupivacaine. Epidural anesthesia: A resource to use judiciously. Intraoperative monitoring, postoperative pain, complications, recovery time, and patient satisfaction at follow-up were compared between the two groups. Discuss with the patient options for anesthesia. Chart and Diagram Slides for PowerPoint - Beautifully designed chart and diagram s for PowerPoint with visually stunning graphics and animation effects. Critical events are highest in infants < 2 kg [Tay et. Cancer Drugs ppt. Hypotension Most common complication Due to sympathetic blockade Treatment: Prophylactic: preloading with 1-1.5L of crystalloid Curative: head low position (15degree) A. Fluids B. Ephedrine (vasopressor) C. Oxygen inhalation. Hammes E: Neurological complications associated with spinal anesthesia (eight cases). The aim of this study is to evaluate the effects of an ERAS pathway for total hip (THR) and knee (TKR) replacement surgery in terms of length of stay . Acta Neurol Psychiatr Belg 1968;68:626 . 38 . Postoperative hypotension can result in spinal cord ischemia. 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