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| | Combined Spinal-Epidural Anesthesia? |
 | | The incidence of spinal anesthesia in an orthopedic institute in Firenze increased from 22% in 1989 to 42% in 1993 (6). | | | Unsuccessful spinal anesthesia was in 12 of the 50 patients (24%) studied. | | | Unsuccessful spinal anesthesia occurred in 8 of the 50 patients (16%). |
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http://www.csen.com/anesthesia/book
(15184 words)
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| | Spinal Anaesthesia - a Practical Guide (page 1) |
| | If a spinal anaesthetic and the ensuing surgery are performed skilfully, the majority of patients are very happy with the technique and appreciate the rapid recovery and absence of side effects. | | | However, special considerations apply to managing spinal anaesthesia in pregnant patients (see later) and it is best to become experienced in its use in the non-pregnant patient before using it for obstetrics. | | | The bowel is contracted during spinal anaesthesia and sphincters are relaxed although peristalsis continues. |
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http://www.nda.ox.ac.uk/wfsa/html/u12/u1208_01.htm
(1509 words)
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| | Naropin® now approved for intrathecal administration in the European Union |
| | Naropin® is currently approved for epidural anaesthesia during surgery and post-operative pain relief, pain relief in childbirth, Caesarean section, local infiltration anaesthesia, for surgery using peripheral nerve block techniques and for continuous peripheral nerve block for post operative pain relief. | | | Spinal (= intrathecal or subarachnoid) block technique involves the injection of local anaesthetic into the cerebrospinal fluid at the lower part of the backbone, thereby temporarily stopping the nerve impulse transmission and the sensation of pain from a part of the body. | | | In clinical studies, Naropin® was shown to provide excellent spinal anaesthesia and muscular relaxation for orthopaedic, gynaecological or urological surgery and was well tolerated. |
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http://www.medicalnewstoday.com/index.php?newsid=6319
(568 words)
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| | Anaesthetic methods for ambulatory knee surgery |
| | The severe neurological complications associated with spinal anaesthesia and other central blocks may be due to the neurotoxic effects of local anaesthetics, direct neural tissue injury caused by a needle or catheter and spinal cord compression by an epidural haematoma or abscess (Alahuhta 2001). | | | There was a difference in the incidence of TNS with no spinal headache in the patients receiving mepivacaine in contrast to 22% of those with lidocaine anaesthesia. | | | Anaesthesia should be specifically tailored for ambulatory surgery, and the anaesthetic drugs must have consistent onset and offset times, permitting rapid changes in the levels of drug effect (Philip 1997). |
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http://herkules.oulu.fi/isbn9514267729/html/x318.html
(4154 words)
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| | [No title] |
| | The incidence of post-dural puncture headache (PDPH) after the use of a standard spinal needle (Quincke) is dependent on the size of the needle. | | | Newer spinal needles with special tip design (modifications of the original pencil point Whitacre needle) have lowered the incidence of PDPH to an acceptable level. | | | introduced the 'atraumatic' spinal needle (a modified pencil point needle) and reported that the incidence of PDPH could be reduced to less than 1%. |
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http://www.frca.co.uk/article.aspx?articleid=100127
(376 words)
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| | Spinal Anaesthesia and Specific CV Conditions |
| | Although the benefits of spinal anaesthesia over general anaesthesia with respect to cardiac morbidity reduction remain unproven, there is no reason to believe that morbidity is increased provided that there is a clear understanding of the haemodynamic effects and of the requirement for appropriate and timely intervention. | | | The reduction in preload associated with spinal anaesthesia can worsen the condition of patients with severe mitral valve prolapse or hypertrophic subaortic stenosis (13) (Chapter 111). | | | In patients with controlled hypertension receiving thoracic epidural anaesthesia, clinical experience suggests that risks are similar to the non-hypertensive population (3). |
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http://www.manbit.com/oa/c83.htm
(1191 words)
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| | welcome to the iaforum.org's january2001 page |
| | The advantages claimed for CSA are- prolonged spinal anaesthesia like a continuos epidural, decreased dose of local anesthetic required as compared to an epidural, less hemodynamic variations following the spinal block as compared to single bolus technique and ability to use intrathecal narcotics spinally for cancer pain relief. | | | Continuos spinal anesthesia with a micro catheter technique. | | | Bizzare D. Continuos spinal anaesthesia, using a special needle and catheter. |
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http://www.theiaforum.org/jan2001.htm
(1379 words)
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| | Surgical Care at the District Hospital |
| | Spinal anaesthesia is a technique commonly used for caesarean section (CS). | | | As soon you have given the spinal and positioned the patient, observe the effects. | | | Practical conduction anaesthesia cannot be learned from a book, but only by working with an experienced practitioner. |
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http://www.steinergraphics.com/surgical/005_14.4.html
(1207 words)
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| | welcome to the iafroum.org's july2ooo page |
| | General anaesthesia in patients with severe pre-eclampsia presents risk to the mother and baby and as with routine caesarian delivery aspiration prophylaxis and left uterine displacement are essential. | | | compared the effects of spinal and epidural anaesthesia for caesarian delivery in severely pre-eclamptic women and concluded that haemodynamic changes were similar in both "single shot" spinal anaesthesia and incremental epidural anaesthesia though it was important to note that the spinal anaesthesia group received 400 ml more crystalloid. | | | Although there are no studies supporting the notion but many anaesthesiologists caring for these patients prefer to choose spinal anaesthesia with a small gauge needle rather than the larger epidural needle. |
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http://www.theiaforum.org/jjuly2000.htm
(1241 words)
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| | SPINAL ANAESTHESIA AND LEFT VENTRICULAR EJECTION FRACTION |
| | Extremely important physiological responses to spinal anaesthesia occur in the cardiovascular system (1). | | | Preload, and consequently, return of venous blood into the heart depends on the positioning of the patient during spinal anaesthesia, and particularly during high spinal anaesthesia. | | | All patients were examined prior to and 5 min after induction of spinal anaesthesia for measurement of left ventricular ejection frection (LVEF) with 2D echocardiography, and MAP and HR changes were noted. |
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http://www.csen.com/anesthesia/ejection-fraction.htm
(1043 words)
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| | A Guide to Spinal Anaesthesia for Caesarean Section for Anaesthetists and Anesthesiologists |
| | Smith reported a 4% spinal headache rate and no failures with a 25G needle, and no spinal headaches but an 8% failure rate with 27G needles. | | | Spinal anaesthesia is an excellent technique for Caesarean section. | | | Using this needle, stay in the midline, pointing slightly towards the patient's head (roughly 80 to 85 degree angle to skin), and insert the needle almost to the hub in the average sized patient. |
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http://www.oyston.com/anaes/local/spinalcs.html
(2108 words)
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| | Regional techniques compared |
| | Overall, because of its advantages spinal anaesthesia (especially with the use of smaller spinal needles) continues to challenge the pre-eminent role of epidural anaesthesia in obstetrics. | | | Except in cases of inadvertent dural puncture with the needle, this problem is not seen with epidural or caudal anaesthesia. | | | Postdural puncture headache may occur in up to 20% of patients when a 25-gauge spinal needle is used (5) (Chapter 97). |
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http://www.manbit.com/OA/c70.htm
(754 words)
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| | Low molecular weight heparins in medicine and anaesthesia |
| | LMWH are associated with an increasing incidence of spinal haematoma in patients undergoing neuraxial anaesthesia, particularly epidurals. | | | Low-molecular-weight heparins are effective in patients with acute spinal cord injuries. | | | Single shot spinal anaesthesia would appear to be the method of least risk. |
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http://www.4um.com/tutorial/currents/lmwh.htm
(2719 words)
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| | JustEves.com - Anaesthesia and You |
| | REGIONAL ANAESTHESIA: This type of anaesthesia only numbs a part of the body by giving a local anaesthetic near a group of nerves and is generally used for less complex procedures. | | | Though blocking the pain signals from the lower half of the body, one is able to move the limbs and feel sensations such as pressure. | | | You will be unconscious during the entire surgery and the face mask may be replaced by an endotracheal tube, which is gently inserted through your mouth into the windpipe. |
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http://www.justeves.com/surgeries/types_of_anaesthesia.shtml
(349 words)
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| | Spinal versus epidural anaesthesia for caesarean section (Cochrane Review) |
| | Spinal anaesthesia has a shorter onset time, but treatment for hypotension is more likely if spinal anaesthesia is used. | | | No difference was found between spinal and epidural techniques with regards to failure rate (RR 0.98, 95% CI 0.23 to 4.24; four studies), need for additional intraoperative analgesia (RR 0.88, 95% CI 0.59 to 1.32; five studies), need for conversion to general anaesthesia intraoperatively, maternal satisfaction, need for postoperative pain relief and neonatal intervention. | | | Authors' conclusions: Both spinal and epidural techniques are shown to provide effective anaesthesia for caesarean section. |
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http://www.cochrane.org/Cochrane/revabstr/ab003765.htm
(479 words)
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| | Article |
| | The incorrect positioning of the introductor is one of the factors that contributed to an increase in the average attempts of spinal needle insertion in group A patients (1.55 versus 1.33) to reach the subarachnoid space. | | | In order to evaluate the technical difficulties in using the needles, the attempts of insertion of the spinal needle and the renunciation to use it, and the partial or total failures, were recorded. | | | The use of a 20G introductor needle was adopted facultatively at the discretion of the anaesthetist. |
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http://www.mednet.odessa.ua/med/anes/1/21.htm
(2431 words)
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| | Characteristics of anaesthesia |
| | The incidence of leg pain and back pain was far higher in the 5% lidocaine spinal anaesthesia group than in the groups with the general anaesthetics used (III), or in the 2% lidocaine spinal anaesthesia group (IV). | | | The pain mechanism in transient lumbar pain might be the straightening of the lumbar lordosis, which is potentiated by the elevation of the legs after lidocaine spinal anaesthesia (Holmdahl 1998). | | | That was the reason for choosing a general anaesthesia method with muscle relaxation and tracheal intubation. |
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http://herkules.oulu.fi/isbn9514267729/html/x2025.html
(1297 words)
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| | VAT - Local and Regional Anaesthesia |
| | Anaesthesia for Opthalmic Surgery Part 1: Regional Techniques in Update in Anaesthesia is an excellent introduction, with clear illustrations. | | | Low Spinal Anaesthesia for Caesarean Section describes 100 cases using this technique. | | | A site about Pain of Circumcision and Pain Control includes some full text references to paediatric pain issues and a warning about the use of EMLA for circumcision. |
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http://www.virtual-anaesthesia-textbook.com/vat/ra.html
(436 words)
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| | CSE Combined Spinal Epidural Anesthesia |
| | A Sprotte spinal needle is inserted coaxially into an Epidural Special Sprotte or Tuohy and emerges through the lateral opening of the Epidural needle. | | | By eliminating friction during the spinal needle's passage through the Tuohy, the important tactile sensation of dura puncture is unobscured. | | | Spinal needle offers the clinician the instruments of choice to perform Combined Spinal/Epidural Anaesthesia through a single puncture. |
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http://www.dynamedical.com/pg2i.html
(236 words)
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| | Guide to Spinal Anaesthesia for Caesarean Section - References |
| | Conclusion: "Spinal anaesthesia does not deserve to remain in the doldrums in obstetrical practice". | | | It helped to ease my transition from being an intern who was useless at lumbar puncture into a resident who was quite good at spinal anaesthesia. | | | Using #25 and #26 guage needles 15 (5.4%) of women developed spinal headaches after Caesarean section. |
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http://www.oyston.com/anaes/local/sp-cs-rf.html
(353 words)
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| | Epidural: spinal anaesthesia |
| | It is used increasingly to provide pain relief, or to reduce the need for deep general anaesthesia – to relax muscles – during childbirth. | | | The epidural space lies between the outermost covering of the spinal cord and the vertebral canal formed by the spine bones. | | | It is also the name given to the most common spinal anaesthetic technique. |
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http://www.ivillage.co.uk/print/0,,163001,00.html
(575 words)
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| | British Medical Journal: Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: ... |
| | Neuraxial blockade has several physiological effects that provide a rationale for expecting to improve outcome with this technique.[2] However, the few clinical trials of epidural or spinal anaesthesia that have focused specifically on fatal or life threatening events have generally been too small to detect effects of plausible size reliably. | | | Although there was limited power to assess subgroup effects, the proportional reductions in mortality did not deafly differ by surgical group, type of blockade (epidural or spinal), or in those trials in which neuraxial blockade was combined with general anaesthesia compared with trials in which neuraxial blockade was used alone. | | | British Medical Journal: Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials |
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http://www.findarticles.com/p/articles/mi_m0999/is_7275_321/ai_68996878
(1017 words)
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| | News - Spinal Anaesthesia May Induce Restless Legs Syndrome |
| | Overall, 8.7 percent of the 161 patients who had no previous history of the condition developed first-onset RLS after spinal anaesthesia. | | | Dr B Hogl and colleagues from the Departments of Neurology and Biostatistics, University of Innsbruck prospectively evaluated 202 consecutive patients who were undergoing spinal anaesthesia for various types of surgery. | | | This is view of researchers in Austria following an investigation of the incidence and time course of new-onset RLS after spinal anaesthesia. |
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http://docguide.com/news/content.nsf/news/8525697700573E1885256C8D00216F23
(381 words)
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| | Epidural or spinal anaesthesia reduces major postoperative complications |
| | Furthermore, the benefits did not differ by the type of surgical group, the type of neuraxial blockade (epidural or spinal), or in trials where neuraxial blockade was combined with general anaesthesia, add the authors. | | | However, given that the risks of fatal or life threatening events are increased several fold after major surgery, these findings support more widespread use of neuraxial blockade, they conclude. | | | Epidural or spinal anaesthesia reduces major postoperative complications |
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http://www.eurekalert.org/pub_releases/2000-12/BMJ-Eosa-1412100.php
(274 words)
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| | MCPC - Spinal (subarachnoid) anaesthesia |
| | Introduce the finest spinal needle available (22- or 23-gauge) in the midline through the wheal, at a right angle to the skin in the vertical plane. | | | Advance the spinal needle towards the subarachnoid space. | | | Do not touch the point or shaft of the spinal needle with your hand. |
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http://www.who.int/reproductive-health/impac/Procedures/Spinal_anesthesia_P11_P12.html
(652 words)
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| | The Worldwide Anaesthetist : Journal Club 27 June 2001 |
| | Article 3: Spinal anaesthesia improves the early recovery profile of patients undergoing ambulatory knee arthroscopy. | | | Backache was commoner in the spinal group (35% vs 14%). | | | Article 2: Small-dose selective spinal anaesthesia for short-duration outpatient gynaecological laparoscopy: recovery characteristics compared with propofol anaesthesia. |
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http://www.anaesthetist.com/anaes/jnl/2001/2001jn27.htm
(600 words)
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| | spinal anaesthesia - definition of spinal anaesthesia by the Free Online Dictionary, Thesaurus and Encyclopedia. |
| | spinal anaesthesia - anesthesia of the lower half of the body; caused by injury to the spinal cord or by injecting an anesthetic beneath the arachnoid membrane that surrounds the spinal cord | | | saddle block anaesthesia, saddle block anesthesia - the parts of a patient's body that would touch a saddle if the patient were sitting in one are anesthetized by injecting a local anesthetic into the spinal cord | | | regional anaesthesia, regional anesthesia - loss of sensation in a region of the body produced by application of an anesthetic agent to all the nerves supplying that region (as when an epidural anesthetic is administered to the pelvic region during childbirth) |
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http://www.thefreedictionary.com/spinal+anaesthesia
(176 words)
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| | Factors affecting spread of spinal anaesthesia |
| | The spread of sensory blockade during spinal anaesthesia is influenced by the following factors: | | | The most significant factors affecting spread of anaesthesia are patient height, patient position and the baricity of the anaesthetic solution. | | | In patients with a decreased volume of CSF (such as parturients, women in the 2nd or 3rd trimester of pregnancy (44), patients with ascites or patients with large intra-abdominal tumours), the spread of spinal anaesthetic solution is greater than normal (4). |
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http://www.manbit.com/oa/C98.htm
(451 words)
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| | Spinal anaesthesia |
| | 25G X 90 mm spinal needle + 30 mm introducer | | | Spinal needle 27G x 103 mm + 23G IV catheter + split introducer |
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http://www.temena.com/pages/spinal.html
(107 words)
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