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Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, [1] is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long.
The drug interactions between sedative-hypnotic agents and adjuvant agents suggest that dosing regimens cannot be fixed. [19] Instead, dosing should be based on adjusted body weight or estimated lean body weight, especially for obese patients. It is recommended that drug doses be titrated in brief intervals (around 20 to 60 seconds). [22]
Medications include ondansetron, granisetron, and dolasetron. Anticholinergics can be used as a long-acting patch placed behind the patient's ear. Adverse effects include dry mouth and blurry vision. Care must be taken when handling the patch, as transfer of medication to the eye can induce pupillary dilation. Avoid use in elderly patients.
Bupivacaine, marketed under the brand name Marcaine among others, is a medication used to decrease sensation in a specific small area. [5] In nerve blocks, it is injected around a nerve that supplies the area, or into the spinal canal's epidural space. [5] It is available mixed with a small amount of epinephrine to increase the duration of its ...
Carbetocin has been approved for use immediately following an elective Cesarean section when a local or spinal anesthesia has been used. [8] Since the uterus cannot contract on its own following incision during a Cesarean section, exogenous administration of oxytocin or an analog is necessary to restore uterine tone and prevent hemorrhage.
Although having many unwanted side-effects, a slow onset of action and recovery rate it was a big success and at the time the most potent neuromuscular drug available. Pancuronium and some other neuromuscular blocking agents block M2-receptors and therefore affect the vagus nerve , leading to hypotension and tachycardia .
Suxamethonium chloride (brand names Scoline and Sucostrin, among others), also known as suxamethonium or succinylcholine, or simply sux in medical abbreviation, [5] is a medication used to cause short-term paralysis as part of general anesthesia. [6] This is done to help with tracheal intubation or electroconvulsive therapy. [6]
Sedation and hypnosis are the principal side effects (occasionally, they are also the intended effects) of phenobarbital. Central nervous system effects, such as dizziness, nystagmus and ataxia, are also common. In elderly patients, it may cause excitement and confusion, while in children, it may result in paradoxical hyperactivity. [37]