Introduction to Regional
- 2. What is Regional Anesthesia?
- 4. Nerve SensitivityAutonomic >> Sensory >> Motor
- 6. Neuraxial Spinal Epidural CaudalPeripheral Nerve BlockIV Regional ( Bier block )
- 11. Local Anesthetic PhysiologyHyperbaric (Dextrose)IsobaricHypobaric
- 12. Spread of Local Anesthesia• Baricity of Local Anesthetic• Position of Patient• Concentration of Local Anesthetic• Volume Injected• Level of Injection• Speed of Injection
- 13. Advantages• Cheap• High Patient Satisfaction• Well Tolerated in Pulmonary Disease• Maintain Patent Airway• Selective Muscle Relaxation• Decreased Blood Loss• Decreased Incidence of DVT and PE
- 14. Disadvantages• Difficult Placement in Elderly• Hypotension• Patient Can Talk• Patient Anxiety• Not Reliable for Surgery > 2 hours
- 15. Complications• Bleeding• Post-Dural Puncture Headache• Transient Neurological Syndrome• Total Spinal
- 16. Total Spinal• Hypotension• Bradycardia• Arm involvement• Shortness of Breath• Patient Anxiety• Loss of Consciousness
- 17. Contra-Indications• Inadequate equipment for GA• Bleeding Dyscrasia’s• Hypovolemia• Patient Refusal• Sepsis/Bactermia• Anatomic Deformities of the Spine• Neurological Disease• Increased ICP• Fixed Cardiac Output States
- 21. Uses• Hip and Knee Surgery• Lower Extremity Vascular Surgery• Lower Extremity Amputation• Obstetrical – Labor & C/S• Thoracic Surgery – Post-Op Pain Control• Thoracic Trauma• Abdominal Surgery – Post-Op Pain Control
- 22. Advantages•Cheap• High Patient Satisfaction• Well Tolerated in Pulmonary Disease• Maintain Patent Airway• Selective Muscle Relaxation• Decreased Blood Loss• Decreased Incidence of DVT and PE
- 23. Disadvantages•Difficult Placement in Elderly• Hypotension• Patient Can Talk• Patient Anxiety
- 24. Complications• High Epidural• Local Anesthetic Toxicity• Total Spinal• Accidental Dural Puncture
- 25. Contra-Indications• Patient Refusal• Coagulopathy• Localized Skin Infection• Elevated ICP• Hypovolemia• Uncooperative Patient• Pre-Existing Neurological Disease• Spinal Column Abnormalities• Fixed Cardiac Output States
- 26. Peripheral Nerve Blocks
- 27. •Brachial Plexus• Psoas Compartment Block• Femoral Nerve Block• PoplitealFossa Block• Ankle Block
- 32. Intravenous Regional Anesthesia ( Bier block )
- 34. Applications•Distal Arm Surgery• Useful for Short Procedures
- 35. Contra-Indications• Sickle Cell Disease• Crush Injury to the Limb• Very Young may need additional
- 36. Complications• Local Anesthetic Toxicity
- 37. THANK YOU