scholarly journals Continuous Spinal Anaesthesia for Intertrochanteric Femur Fracture in a Patient with Skeletal Dysplasia

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sharad Khakurel ◽  
Rupesh Kumar Yadav
Keyword(s):  
Spinal Anaesthesia ◽  
Skeletal Dysplasia ◽  
Single Shot ◽  
Hyperbaric Bupivacaine ◽  
Continuous Spinal Anaesthesia ◽  
Neuraxial Blockade ◽  
Formidable Challenge ◽  
Cardiac Illness ◽  
Intertrochanteric Femur Fracture ◽  
Clinical Conditions

The practice of continuous spinal anaesthesia is not common. Though underutilised, it offers significant advantage when compared to the single-shot technique nonetheless. Time and again, it has proven its worth in patients with advanced cardiac illness, spinal deformities, and obesity. We here successfully employed this neuraxial anaesthetic technique in a sixty-two-year-old male patient with skeletal dysplasia, who presented for surgical fixation of intertrochanteric fracture of the femur. With short stature, anticipated difficult airway, and poor pulmonary status complicating the anaesthetic plan, we opted for continuous spinal anaesthesia. The procedure was carried out uneventfully with 8 mg of hyperbaric bupivacaine used in titration to anaesthetic needs. Patients with skeletal dysplasia present with wide array of clinical conditions that pose a formidable challenge to anaesthesiologists. Continuous spinal anaesthesia can be safely practiced in such patients as it provides a titratable form of neuraxial blockade with reduced dose of local anaesthesia. This, in turn, ensures a predictable block and, thus, hemodynamic stability.

scholarly journals Complications of Continuous Spinal Anaesthesia

1992 ◽  
Vol 20 (4) ◽  
pp. 417-425 ◽  
Author(s):  
P. J. Peyton
Keyword(s):  
Spinal Anaesthesia ◽  
Current Practice ◽  
Dural Puncture ◽  
Single Shot ◽  
Continuous Spinal Anaesthesia ◽  
Post Dural Puncture Headache ◽  
History Of ◽  
Nerve Trauma

The practice of continuous spinal anaesthesia dates back to the beginning of the century. The history of the technique, and the problems which accompanied each method used, are reviewed. Complications encountered in current practice include post dural puncture headache; technical difficulties with insertion and removal of catheters; and a higher potential for nerve trauma, neurotoxicity, and method failure than seen with single-shot spinal anaesthesia. The question of the place of the technique in modern anaesthesia is addressed.

scholarly journals Sensory Block Level Prediction of Spinal Anaesthesia With 0.5% Hyperbaric Bupivacaine: A Retrospective Study

2020 ◽  
Author(s):  
Yu-Yin Huang ◽  
Kuang-Yi Chang
Keyword(s):  
Retrospective Study ◽  
Predictive Model ◽  
Spinal Anaesthesia ◽  
Linear Regression Analysis ◽  
Sensory Block ◽  
Multiple Linear Regression Analysis ◽  
Single Shot ◽  
Hyperbaric Bupivacaine ◽  
Block Height ◽  
Block Level

Abstract There is still no consensus on how to determine the dose of spinal anaesthesia with adequate sensory block for a planned surgery. This retrospective study aimed to explore the associations of miscellaneous factors with peak sensory block level after spinal anaesthesia with hyperbaric bupivacaine, and to construct a predictive model for single-shot spinal anaesthesia. We collected the records of 401 non-pregnant adults who underwent spinal anaesthesia with 0.5% hyperbaric bupivacaine at the L3-4 or L4-5 intervertebral space for lower body surgeries. Multiple linear regression analysis was used to investigate predictors of the block level and build up the predictive model. Five variables were identified as independent predictors of the peak sensory block level, including bupivacaine dose, height, weight, gender and age. The predictive model for peak block level after spinal anaesthesia could be expressed as a formula with these five variables and the estimated predictive power was 0.72. Based on this model, it is possible to determine a reasonable dose of hyperbaric bupivacaine for spinal anaesthesia, which gives adequate sensory block required for diverse surgical procedures in various patients and could be considered as a dose reference for sensory block height in spinal anaesthesia.

scholarly journals Sensory block level prediction of spinal anaesthesia with 0.5% hyperbaric bupivacaine: a retrospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu-Yin Huang ◽  
Kuang-Yi Chang
Keyword(s):  
Retrospective Study ◽  
Predictive Model ◽  
Spinal Anaesthesia ◽  
Linear Regression Analysis ◽  
Sensory Block ◽  
Multiple Linear Regression Analysis ◽  
Single Shot ◽  
Hyperbaric Bupivacaine ◽  
Block Height ◽  
Block Level

AbstractThere is still no consensus on how to determine the dose of spinal anaesthesia with adequate sensory block for a planned surgery. This retrospective study aimed to explore the associations of miscellaneous factors with peak sensory block level after spinal anaesthesia with hyperbaric bupivacaine, and to construct a predictive model for single-shot spinal anaesthesia. We collected the records of 401 non-pregnant adults who underwent spinal anaesthesia with 0.5% hyperbaric bupivacaine at the L3–4 or L4–5 intervertebral space for lower body surgeries. Multiple linear regression analysis was used to investigate predictors of the block level and build up the predictive model. Five variables were identified as independent predictors of the peak sensory block level, including bupivacaine dose, height, weight, gender and age. The predictive model for peak block level after spinal anaesthesia could be expressed as a formula with these five variables and the estimated predictive power was 0.72. Based on this model, it is possible to determine a reasonable dose of hyperbaric bupivacaine for spinal anaesthesia, which gives adequate sensory block required for diverse surgical procedures in various patients and could be considered as a dose reference for sensory block height in spinal anaesthesia.

Neuraxial anaesthesia for caesarean delivery

2016 ◽  
Author(s):  
Sarah L. Armstrong ◽  
Michelle Walters ◽  
Katherine Cheesman ◽  
Geraldine O’Sullivan
Keyword(s):  
Local Anaesthetic ◽  
Epidural Anaesthesia ◽  
Caesarean Delivery ◽  
Preoperative Assessment ◽  
Single Shot ◽  
Failed Intubation ◽  
Continuous Spinal Anaesthesia ◽  
Neuraxial Blockade ◽  
Neuraxial Anaesthesia ◽  
Spinal Epidural

Neuraxial anaesthesia is the safest and preferred method of anaesthesia for both elective and emergency caesarean delivery. It has significant advantages over general anaesthesia including the avoidance of failed intubation and ventilation, awareness, and aspiration of pulmonary contents. It also allows the partner to be present at delivery and facilitates maternal–newborn bonding. This chapter examines the indications and contraindications to neuraxial blockade for caesarean delivery and discusses preoperative assessment and consent for these patients. Neuraxial techniques for caesarean delivery include single-shot spinal, combined spinal–epidural, epidural anaesthesia, and continuous spinal anaesthesia. These techniques are described and critically evaluated. The choice of local anaesthetic drugs and adjuvants is also discussed along with a troubleshooting section for dealing with unexpected complications of neuraxial blockade for caesarean delivery.

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