Total Spinal Anesthesia

Total Spinal Anesthesia - Total Spinal Anesthesia Following...

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Total Spinal Anesthesia Following Subarachnoid Injection of Local Anesthetic for Cesarean Section (Two Case Reports) Dmitry Portnoy, MD Anesthesiology Department
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Case # 1. Preoperative Assessment 21 y/o, G1, at 41 weeks induced for postdates, suspected chorioamnionitis. No previous medical or surgical history. System review was unrevealing, NKDA PE unremarkable, Wt-76 kg, Ht-5’3’’ VS: BP-99/54, HR-82, RR-20, low FHR baseline AW: MP-I, TMD - 6 cm, neck - FROM, mouth opening - 4.5 cm.
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Timeline 1740 Active labor, Cx - 7 cm. CSE – immediate pain relief. 2025 LEA activated after negative standard test dose. 0145 Called for c/s(failure to descend); Pump off; Pt reported some right-sided pain. LEC pulled back 1 cm. 0155 LEA activated with total of 15 cc of 3% chloroprocaine. Sensory block remains considerably inadequate on right side. 0210 To OR; LEC removed intact; SAH done at L2-L3, sitting with 1.2 cc(9,0 mg) of 0.75% Bup + 25 mcg Fentanyl + Epi 0214 Total spinal developed. EZ ventilation with cricoid pressure. Uneventful tracheal intubation following 250 mg of STP. 0234 Baby delivered without incident with Apgar 8 and 9. 0310 Extubated awake, in full strength, with airway reflexes intact. 0320 To PACU, VSS, sensory block at T3. POD # 2 Discharged home in good condition.
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Spinal Following Epidural Controversy J.H.Waters compared epidural/spinal and spinal alone ( Anesthesia and Analgesia,1994;78:1029-35 ). Similar sensory level in both groups
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This note was uploaded on 12/28/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Total Spinal Anesthesia - Total Spinal Anesthesia Following...

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