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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.
But in the elderly several factors makes taking history more difficult and time-consuming. Many differences can be seen in geriatric anesthesia. First, the preoperative evaluation of the geriatric patient is typically more complex than that of the younger patient because of the heterogeneity of this patient group and the greater number and ...
Lumbar punctures may also be done to inject medications into the cerebrospinal fluid ("intrathecally"), particularly for spinal anesthesia [10] or chemotherapy. Serial lumbar punctures may be useful in temporary treatment of idiopathic intracranial hypertension (IIH). This disease is characterized by increased pressure of CSF which may cause ...
In adults, the spinal cord terminates around the level of the disc between L1 and L2, while in neonates it extends to L3 but can reach as low as L4. [16] Below the spinal cord there is a bundle of nerves known as the cauda equina or "horse's tail". Hence, lumbar epidural injections carry a low risk of injuring the spinal cord.
Total intravenous anesthesia (TIVA) refers to the intravenous administration of anesthetic agents to induce a temporary loss of sensation or awareness. The first study of TIVA was done in 1872 using chloral hydrate , [ 1 ] and the common anesthetic agent propofol was licensed in 1986.
Options include succinylcholine, rocuronium, vecuronium, mivacurium, atracurium and cisatracurium. [12] The choice among these NMBA depends on availability, cost and patient parameters that affect drug metabolism. Intraoperative relaxation can be maintained as necessary with additional dose of nondepolarizing NMBA. [12]
Anesthesia – pharmacologically induced and reversible state of amnesia, analgesia, loss of responsiveness, loss of skeletal muscle reflexes or decreased sympathetic nervous system, or all simultaneously. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience.
Treatment options to prevent PONV include medications such as antiemetics (for example, ondansetron or dexamethasone) or other drugs including tropisetron, dolasetron, cyclizine, and granisetron. Droperidol may cause QT prolongation and is not frequently used. [ 1 ]
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