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14 Cards in this Set
- Front
- Back
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Who invented the hollow needle and glass syringe? |
Alexander Wood, 1853 |
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Who demonstrated the anaesthetic properties of cocaine on the eye? |
Carl Koller |
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Who first noted the pain relief felt by their patient after injecting them with cocaine? |
James Corning, 1885 |
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What is spinal anaesthesia? |
Passing a needle into the lumbar spine, through the skin, fat, Interspinous ligament, Ligamentum flavum, epidural space and dura |
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Where is a spinal injection typically administered? |
Below L1-2 |
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Why should a patient lean forwards when getting a spinal injection? |
To widen the gaps between vertebrae, allowing easier injection |
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What are the features of a spinal injection? |
0.5% bupivacaine with 6% glucose (to make it heavier than CSF) 2-3 mls Into the lumbar CSF which bathes the cauda equina 5-15 min onset, lasts 1-2 hours Blocks all nerves and modalities below injection level, typically T10 downwards |
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How can a spinal anaesthetic be used to anaesthetise levels higher than the injection site? |
Due to the thoracic kyphosis, if a patient lies on their back after a spinal injection, the anaesthetic will flow down and interact with the thoracic spine up to around T6 |
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What are the adverse effects of spinal injections? |
Hypotension - 100% Bradycardia (if block reaches T1-4) - 20% Headache - 1% Nerve damage, meningitis, deafness - very rare |
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What is an epidural anaesthetic? |
An injection into the epidural space, doesn't go quite as far as spinal |
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Describe the features of an epidural injection |
- either 0.5% bupivacaine or 2% lidocaine + adrenaline (to constrict arteries and prevent spread to rest of body) - 20mls - usually into the lumbar epidural space, but can be used in thoracic and sacral regions too - 10-30min onset, up to 6hr lasting - blocks all nerves and modalities in a band around affected region, because the spinal nerves are affected instead of the spine itself |
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What are the adverse effects of epidural injections? |
Hypotension, Bradycardia and shivering. |
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What is epidural injection commonly used for? |
During labour for childbirth, as a form of analgesia |
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What is the Tuohy technique? |
Upon original insertion of the epidural needle, a catheter is also inserted, allowing easy top ups for prolonged use. |
