Regional anesthesia PPT

June 28, 2012 | By | Reply More

Regional anesthesia PPT

Powerpoint lecture slide

Regional anesthesia – Definition

Rendering a specific area of the body, e.g. foot, arm, lower extremities, insensate to stimulus of surgery or other instrumentation

Regional anesthesia – Uses

•Provide anesthesia for a surgical procedure
•Provide analgesia post-operatively or during labor and delivery
•Diagnosis or therapy for patients with chronic pain syndromes
Regional anesthesia – types
•Topical
•Local/Field
•Intravenous block (“Bier” block)
•Peripheral (named) nerve, e.g. radial n.
•Plexus – brachial, lumbar
•Central neuraxial – epidural, spinal
Topical Anesthesia
•Application of local anesthetic to mucous membrane – cornea, nasal/oral mucosa
•Uses :
–awake oral, nasal intubation, superficial surgical procedure
•Advantages :
–technically easy
–minimal equipment
•Disadvantages :
–potential for large doses leading to toxicity
Picture1 Regional anesthesia PPT
Local/Field Anesthesia
•Application of local subcutaneously to anesthetize distal nerve endings
•Uses:
–Suturing, minor superficial surgery, line placement, more extensive surgery with sedation
•Advantages:
–minimal equipment, technically easy, rapid onset
•Disadvantages:
–potential for toxicity  if  large field
IV Block – “Bier” block
•Injection of local anesthetic intravenously for anesthesia of an extremity
•Uses
–any  surgical procedure on an extremity
•Advantages:
–technically  simple, minimal equipment, rapid onset
•Disadvantages:
duration limited by tolerance of  tourniquet pain, toxicity
Picture2 Regional anesthesia PPT
Peripheral nerve block
•Injecting local anesthetic near the course of a named nerve
•Uses:
– Surgical procedures in the distribution of the blocked nerve
•Advantages:
–relatively small dose of local anesthetic to cover large area; rapid onset
•Disadvantages:
–technical complexity, neuropathy
Picture3 Regional anesthesia PPT
Plexus Blockade
•Injection of local anesthetic adjacent to a plexus, e.g cervical, brachial or lumbar plexus
•Uses :
– surgical anesthesia or post-operative analgesia in the distribution of the plexus
•Advantages:
–large area of anesthesia with relatively large dose of agent
•Disadvantages:
–technically  complex, potential for toxicity and neuropathy.
Central neuraxial blockade – “Spinal”
•Injection of local anesthetic into CSF
•Uses:
–profound anesthesia of lower abdomen and extremities
•Advantages:
–technically  easy  (LP technique), high success rate, rapid onset
•Disadvantages:
–“high spinal”, hypotension due to sympathetic block, post dural puncture headache.
Central Neuraxial Blockade – “epidural”
•Injection of local anesthetic in to the epidural space at any level of the spinal column
•Uses:
–Anesthesia/analgesia of the thorax, abdomen, lower extremities
•Advantages:
–Controlled onset of blockade, long duration when catheter is placed, post-operative analgesia.
•Disadvantages:
–Technically complex, toxicity, “spinal headache”
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