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NURS 5450 Exam 1 - Basics of Neuraxial Anesthesia Test With Complete Solution
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NURS 5450 Exam 1 - Basics ofNeuraxial Anesthesia Test With
Complete Solution
Spinal and Epidural Anesthesia are collectively referred to as ______.
central neuraxial block
Clinical uses for neuraxial anesthesia include:
• Can be the sole surgical anesthetic (c section)
• Useful in conjunction with procedural sedation (hip fracture)
• Can be an adjunct to general anesthesia (combined technique)
• → an effective method in providing postoperative pain control
• Chronic pain management
How is spinal anesthesia accomplished?
By injecting local anesthetic solution
into the CSF contained within the subarachnoid (intrathecal) space
________ is limited to the lumbar region below the spinal cord.
Subarachnoid block (SAB)
The spinal cord ends at the level of vertebrae ________, while the subarachnoid space
—the compartment that contains cerebrospinal fluid— extends down to the lower
border of S2.
,L1-L2
How is epidural anesthesia accomplished?
By injection of local anesthetic solution into the space that lies within the vertebral
canal but outside or superficial to the dural sac
Where can epidural anesthesia be performed in the spinal column?
Various Levels - (cervical, thoracic,
lumbar)
What is caudal anesthesia?
A special type of epidural anesthesia
where local anesthesia is injected through the sacral hiatus into the epidural space
What are the benefits of a SAB?
Typically takes less time to perform
- Causes less procedural discomfort
- Requires less anesthetic
- Produces a more intense block (motor and sensory)
- Easily confirmed with the appearance of
CSF
What are the benefits of an epidural anesthetic?
- Has a decreased risk of postdural puncture headache (PDPH) - unless you nick the
arachnoid membrane - "wet tap"
, - Lower incidence of systemic hypotension
- Has the ability to produce a segmental sensory block
- Greater control over the intensity of the sensory and motor block
- Provides a portal for subsequent local anesthetic and/or narcotic administration
What are some pros of using neuraxial anesthesia?
• The patient can remain completely awake for the operative procedure
• Skeletal muscle relaxation is profound with neuraxial blockade → no need for
neuromuscular blocking agents
What are some cons of using neuraxial anesthesia?
- Patient anxiety (real and unfounded)
What is the primary concern with neuraxial anesthesia for procedures of the upper
abdomen?
Respiratory compromise - due to the level needed for proper sensory block →
combined anesthetic technique
What are the indications for neuraxial anesthesia?
Surgical procedures of the:
• Lower abdominal area
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