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ANATOMY OF SPINAL CORD

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

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ANATOMY OF SPINAL CORD

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  1. ANATOMY OF SPINAL CORD

  2. SPINAL ANESTHESIA

  3. ANAESTHETICS USED HYPERBARIC (HEAVY)‏ LIGNOCAINE 5% IN 7.5%DEXTROSE BUPIVACAINE 0.5% IN 5% DEXTROSE

  4. HOW A HEAVY ANAESTHETICSOLUTION FLOWS IN CSF

  5. 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)‏

  6. CONTRAINDICATIONS • Unco-operative patient • Operations lasting more than 2 hours • Hypovolemic shock • Children • Sepsis anywhere on the back • Operations on the thorax and above

  7. TECHNIQUE • Preload with 500- 1000ml crystalloid • Premedicate – pentazocine,prometazine, atropine • Moniter BP,pulse and O2 sat, heart rhythm

  8. 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

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