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Intrathecal administration is a route of administration for drugs via an injection into the spinal canal, or into the subarachnoid space so that it reaches the cerebrospinal fluid (CSF). It is useful in several applications, such as for spinal anesthesia , chemotherapy , or pain management .
Differences include: A spinal anaesthetic delivers drug to the subarachnoid space and into the cerebrospinal fluid (CSF), allowing it to act on the spinal cord directly. An epidural delivers drugs outside the dura (outside CSF), and has its main effect on nerve roots leaving the dura at the level of the epidural, rather than on the spinal cord ...
Medical intervention Epidural administration A freshly inserted lumbar epidural catheter. The site has been prepared with tincture of iodine, and the dressing has not yet been applied. Depth markings may be seen along the shaft of the catheter. ICD-9-CM 03.90 MeSH D000767 OPS-301 code 8-910 [edit on Wikidata] Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method ...
For epidural anesthesia an anesthetic agent is injected into the space just outside the thecal sac and diffuses through the dura to the nerve roots where they exit the thecal sac. [4] [5] For spinal anaesthesia in general, an injection can be given intrathecally into the subarachnoid space, or into the spinal canal.
The definition of the topical route of administration sometimes states that both the application location and the pharmacodynamic effect thereof is local. [ 3 ] In other cases, topical is defined as applied to a localized area of the body or to the surface of a body part regardless of the location of the effect.
Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury and at rest, is normally 7–15 mmHg for a supine adult. This equals to 9–20 cmH 2 O, which is a common scale used in lumbar punctures. [1]
Combined spinal and epidural anaesthesia in labouring women is associated with more pruritus if fentanyl (25 μg) is given intrathecally, than low-dose epidural analgesia. However, no difference has been found in the incidence of post dural puncture headache , requirement for epidural blood patch or maternal hypotension.
In the setting of raised pressure (or normal pressure hydrocephalus, where the pressure is normal but there is excessive CSF), lumbar puncture may be therapeutic. [27] Decreased CSF pressure can indicate complete subarachnoid blockage, leakage of spinal fluid, severe dehydration, hyperosmolality, or circulatory collapse. Significant changes in ...