Experimental model for local anesthetic spread in spinal anesthesia: application to medical education

The spinal anesthesia, a category of neuraxial anesthesia, is commenced in the lumbar spine, where the local anesthetic (LA) is injected into cerebrospinal fluid (CSF) to anesthetize the spinal nerves. This technique is most frequently used for analgesia and/or anesthesia for different forms of lower extremity, lower abdominal, pelvic, and perineal procedures. Preoperative evaluation that includes a medical history and anesthesia-directed physical examination should be performed for every patient who undergo any type of anesthesia. Focus should be made on the preoperative evaluation, when spinal anesthesia is considered, to prevent medical conditions that may alter the physiologic response to spinal anesthesia or increase the risk of complications and the baricity influences of the anesthetic distribution within the subarachnoid space.

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The Effect of Injection Speed of Local Anesthetic on Success Rate of Unilateral Spinal Anesthesia

Korean Journal of Anesthesiology ◽

10.4097/kjae.2005.49.6.793 ◽

2005 ◽

Vol 49 (6) ◽

pp. 793 ◽

Cited By ~ 1

Author(s):

Hyun Sook Cho ◽

Youn Suk Son ◽

Kyu Don Chung ◽

Won Hyung Lee ◽

Jong Min Park ◽

...

Keyword(s):

Success Rate ◽

Spinal Anesthesia ◽

Local Anesthetic ◽

Injection Speed ◽

Unilateral Spinal Anesthesia

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Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension

QJM ◽

10.1093/qjmed/hcab086.035 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Saeed Mohamed Ibrahim ◽

Rania Mahrous Aly Hussien ◽

Hazem Mohamed Sabry Abdel Aziz Ahmed

Keyword(s):

Spinal Anesthesia ◽

Local Anesthetic ◽

Normal Saline ◽

Demographic Data ◽

Randomized Study ◽

P Value ◽

Anthropometric Measures ◽

Double Blind ◽

Induced Hypotension ◽

Significant Difference

Abstract Background Spinal Anesthesia is a common type of anesthesia used during many surgical procedures. This regional technique can be accomplished by administering an intrathecal dose of hyperbaric local anesthetic solution. The local anesthetic within the subarachnoid space can block sensory, motor and sympathetic pathways. Objectives The Purpose of this study was to find out the effectiveness of prophylactic administration of intravenous ondansetron for attenuation of spinal anesthesia induced hypotension in non-obstetric spinal anesthesia surgeries. Patients and Methods Therefore, A prospective double-blind, placebo-controlled, randomized study was found to be the most suitable design in order to achieve the study objectives. A total of 90 patients males & females included in the study, aged 20-40 years, and were divided equally into two groups: Group A received 8 mg ondansetron diluted in volume of 10 cm normal saline 5 minutes prior to spinal anesthesia. Group B received a placebo of 10 cm normal saline 5 minutes prior to spinal anesthesia. Results There was no statistically significant difference found between the two studied groups regarding demographic data, anthropometric measures, ASA score and total time of surgery. There was statistically significant increase in the incidence of hypotension immediately after spinal and at 5 min in placebo group than ondansetron group with p-value = 0.026 and 0.014 respectively. Conclusion The present study demonstrated that, among patients who received spinal anesthesia with bupivacaine for elective for surgeries below umbilicus, prophylactic intravenous ondansetron 8mg iv 5 mins prior to spinal anesthesia reduced spinal anesthesia induced hypotension decreases in SBP, MAP, and heart rate. Ondansetron did not have a significant effect on DBP. Ondansetron did not have a significant effect on DBP. The incidence of nausea and vomiting was lower following the administration of ondansetron, and vasopressor use and dosages were reduced.

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