Ultrasound Artifacts

Ultrasound Artifacts 1-Reverberation artifact: ➧ The processing unit in the ultrasound machine assumes echoes return directly to the processor from the point of reflection.  ➧ Depth is calculated as D = V × T, where V is the speed of sound in biological tissue and is assumed to be 1,540 m/sec, and T is time.  ➧ In a reverberation artifact, the...

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Accidental Total Spinal Anesthesia

Accidental Total Spinal Anesthesia Definition: ➧ A syndrome of the central neurological blockade.  ➧ It occurs when a volume of local anesthetic (LA) solution, intended for epidural anesthesia, enters the subarachnoid space and ascends to the cervical region. Causes:  a) After a known dural tap:  ➧ Accidental total spinal analgesia may occur...

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Failed Spinal Anesthesia

Failed Spinal Anesthesia Introduction: ➧ Spinal (intrathecal) anesthesia is one of the most reliable regional block methods: the needle insertion technique is relatively straightforward, with cerebrospinal fluid (CSF) providing both a clear endpoint of successful needle placement and a medium for carriage of local anesthetic (LA) within subarachnoid space. However, the...

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Management of Failed Spinal Anesthesia

Management of Failed Spinal Anesthesia ➧ Failure of a spinal anesthetic is an event of significant concern for both patient and anesthetist when it is immediately apparent, but it can have serious consequences (clinical and medico-legal) if the problem only becomes evident once surgery has started. ➧ This can be a source of pain, anxiety, and psychological...

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Needle Misplacement during Caudal block

Needle Misplacement during Caudal block Sites of Misplacement: A-SubperiostealB-False decoy hiatusC-posterior sacral ligamentD-Anterior sacral wallE-BoneF-Lateral foramen...

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Failed Epidural Block

Failed Epidural Block Introduction: ➧ Failure of epidural anesthesia and analgesia occurs in up to 30% of clinical practices.  ➧ Some technical factors can help to increase the primary and secondary success rates. A) Technical factors influencing block success: 1-Patient Position: ➧ Patient positioning potentially affects needle placement by changing the relationship...

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Local Anesthetic Toxicity

Local Anesthetic Toxicity Clinical Manifestations & Management:  1-CNS manifestations:  ➧ Early signs: circumoral numbness (Earliest sign), tongue paresthesia, dizziness ➧ CNS Excitation: (restlessness and agitation) ➧ CNS Depression: (slurred speech, drowsiness, unconsciousness) ➧ Muscle twitching, tonic-clonic seizures ➧ Respiratory...

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