How and why to do an epidural in dogs and cats? Which Indications and which drugs?
|
|
- Amberlynn Ward
- 5 years ago
- Views:
Transcription
1 AMVAC/RoSAVA 2014 How and why to do an epidural in dogs and cats? Which Indications and which drugs? Prof. Yves Moens Dipl ECVAA
2 Why do epidurals? A part of a balanced anesthesia A means to provide analgesia
3 Terminology is injection in the extradural space Peridural Extradural
4 Terminology injection in the subdural space subdural Subarachnoidal Spinal
5 Materials needed Anaesthetic Drugs Saline Spinal needle Ordinary needle Syringues : for drugs / for saline
6 Materials needed
7 Spinal needles 22 GA (O.7 x 40 mm) 22 GA (O.7 x 75 mm) 22 GA (O.7 x 120 mm) The mark on the needle hub indicates the direction of the bevel opening
8 Preparation and Clipping? Large area or conservative? (asepsis) Inform / consult the owner!!!! cases of slow hair regrowth cases of changed hair pigmentation
9 Positioning? Dorsal Recumbency Lateral recumbency
10 Where?: foramen lumbosacrale Liquor Dura Cauda equina Venous plexus! Dural sac is longer in the cat than in the dog!
11 landmarks for the foramen
12 landmarks for the foramen
13 Landmarks for the foramen TAIL
14 Where?: foramen lumbosacrale Dog 1/2 Cat 1/3
15 Landmarks for the foramen
16 Extradural penetration: how do I know? The pop -feeling (trough Lig. Flavum) The hanging drop technique The loss of resistance to saline or air
17 The Pop feeling POP!!
18 The Hanging drop sign The aspiration of fluid from the needle hub due to subatmospheric pressure in the extradural space Not always! Never in lateral recumbency If present: correct location If not present: no information
19 The Loss of resistance - test (LOR) Ideally with special syringues LOR-test preferred with saline Introduce an air bubble compression: false no change: correct!
20 The Loss of resistance - test (LOR)
21 how to proceed : part 1 Palpate the landmarks Advance the needle in direction foramen Pop feeling? If yes: adequate length of insertion of the needle? If yes: remove the stylet - LOR-test with saline If positive: inject slowly the drugs
22 how to proceed : part 2 Palpate the landmarks Advance the spinal needle in direction of the foramen Pop feeling?: No Touch bone? Yes adequate length of insertion of the needle? yes Withdraw a few mm Remove the stylet - LOR-test with saline If positive: inject slowly the drugs We have hit the bottom of the spinal canal
23 how to proceed : part 3 Palpate the landmarks Advance the spinal needle in direction of the FO Pop feeling?: No Touch bone? Yes Adequate length of insertion of the needle? NO walk the bone until sudden further penetration Touch bone again? Withdraw a few mm Remove stylet -LOR-test with saline If positive: inject slowly the drugs
24 walk the bone
25 walk the bone
26 problems Blood from the needle hub? abort Cerebrospinal fluid from the needle hub: inject slowly half the dose position head high No local anaesthetics spinally in hypovolemic patients Inject slowly
27 An Example 1
28 An Example 2
29 Contraindications for epidural analgesia Coagulopathies Severe bacteremia Infection at the site of needle placement Lumbosacral fractures or dislocations Thoracolumbal neurologic deficits Hypovolemia (to be corrected!!)
30 Advantages of epidural analgesia Long lasting pain relief possible (>10 hrs) not limited to the hindquarters!! somatic and visceral pain Can simplify pain management Less systemic side effects of epidurally administered analgesics less cardiorespiratory side effects less sedative side effects No or less systemic analgesics needed facit Y Moens
31 AMVAC/RoSAVA 2014 Disadvantages Risks of the epidural technique itself Infection mechanical or chemical damage to the cord Often need for heavy sedation or short general anesthesia to perform Side effects of the epidural drugs For prolongation repeated epidural puncture and injection necessary Increased risk facit Y Moens
32 AMVAC/RoSAVA 2014 Common drugs Opioids: MORPHINE Interfere with nociceptive processing by binding to opiate receptors in the dorsal horn of the spinal cord Local anesthetic: BUPIVACAINE stop nerve conduction and thus ascending nociceptive input by blocking ion channels of the nerve membranes wher they leave the spinal cord facit Y Moens
33 AMVAC/RoSAVA 2014 Common drugs : morphine More hydrophilic opioid easy cranial spread up to the forelimb-level!! slow onset (1-2 hrs) long action (10 hrs) No motor blockade! Side effects are seldom Interference with urination: bladder atony (m.detrusor) Bladder control necessary: assistance/catheter might be necessary facit Y Moens
34 Common drugs : bupivacaine motor blockade! % < 0.25 % < 0.50 % quick onset (30 min) medium duration (4-6 hrs) autonomic blockade sympathicolysis and vasodilation risk for hypotension!!! If hypovolemic!! cranial spread depends on dosis and volume and body position up to mid thoracic level nociceptive block not always complete facit Y Moens
35 AMVAC/RoSAVA 2014 Common individual drug doses First choice : Morphine: mg/kg Second choice: Bupivacaine: mg/kg (degree of motor block) Drug volume: analgesic drugs are diluted if necessary to make up a volume of 0.1 ml to 0.2 ml/kg (cranial spread ± influenced ) facit Y Moens
36 Morphine PLUS bupivacaine Synergistic effect!! More analgesic potency Longer duration Reduction doses of individual drugs In presence of morphine bupivacaine % or even 0.06 % can be used. eg 50/50 mixture of morfine (1mg/ml) and 0.25% bupivacaine can be used facit Y Moens
37 AMVAC/RoSAVA 2014 Some indications for epidural analgesia All trauma /surgery hind part of the body Limb amputations (for-and hindlimb) Thoracotomy - trauma thoracic wall Pancreatitis Peritonitis facit Y Moens
38 AMVAC/RoSAVA 2014 Remarks Cats: lower doses and volumes in general Use by preference preservative free drugs Inadvertent spinal puncture (csf fluid): abort or reduce the dose Systemic analgesics (can)remain necessary but at lower doses No cook book: pain evaluation (scoring) is the key of good pain management!!! facit Y Moens
39 AMVAC/RoSAVA 2014 Epidural analgesia via an epidural catheter Not the first procedure to learn Severe pain expecting to last long Same contraindications as epidural needle injection Absolute sterile conditions during placement 3 days in place is common Specific risks related to epidural catheter Protection to prevent removal by animal facit Y Moens
40 AMVAC/RoSAVA 2014 epidural analgesia via an epidural catheter 1 facit Y Moens
41 AMVAC/RoSAVA 2014 epidural analgesia via an epidural catheter 2 facit Y Moens
42 AMVAC/RoSAVA 2014 Questions possible but facit Y Moens
43 AMVAC/RoSAVA 2014 conclusion Epidural application of analgesic drugs is relatively simple The combination of drugs that act upon (loc anesth) and in (opiod) the spinal cord is synergistic Goal is improved analgesia with less side effects and faster recovery of normal behaviour the gain outweight the risks facit Y Moens
44 AMVAC/RoSAVA 2014 problems Blood from the needle hub? abort Cerebrospinal fluid from the needle hub: inject slowly half the dose position head high No local anaesthetics spinally in hypovolemic patients Inject slowly facit Y Moens
45 An example:dog sternal Cat lateral facit Y Moens
46 AMVAC/RoSAVA 2014 An example: Dog lateral facit Y Moens
47 AMVAC/RoSAVA 2014 An example:: Cat lateral facit Y Moens
48 AMVAC/RoSAVA 2014 epidural analgesia via an epidural catheter 3 facit Y Moens
Epidural anaesthesia and analgesia
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Epidural anaesthesia and analgesia Author : Matthew Gurney Categories : Vets Date : June 1, 2009 Matthew Gurney discusses
More informationEpidural analgesia technique
Epidural analgesia technique Martin Pearson School of Veterinary Science University of Queensland, Gatton 0254601834 Peter Best Greencross South Tamworth Animal Hospital 88Duri Road, Tamworth 02 6765 4244
More informationEldor Epidural Kit (CSEN 68) Epidural catheter technique
Eldor Epidural Kit (CSEN 68) Epidural catheter technique Using the epidural needle the epidural space is reached by the loss of resistance technique or the hanging drop technique, while the proximal opening
More informationCommon Dosages** Fentanyl CRI Loading Dose 5 to 10 mcg/kg CRI 0.3 to 1.0mcg/kg/min (anes)
ADVANCED ANESTHETIC AND ANALGESIC TECHNIQUES Jody Nugent-Deal, RVT, VTS (Anesthesia/Analgesia) (CP-Exotic Companion Animal) University of California Davis, William R. Pritchard Veterinary Medical Teaching
More informationEpidural Analgesia in Labor - Whats s New
Epidural Analgesia in Labor - Whats s New Wichelewski Josef 821 Selective neural blockade has many clinical applications in medicine but nowhere has its use been so well accepted than in the field of Obstetrics.
More informationLocal anaesthetic techniques
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Local anaesthetic techniques Author : CARL BRADBROOK Categories : Vets Date : June 30, 2014 CARL BRADBROOK BVSc, CertVA, DipECVAA,
More informationRegional Anesthesia. Fatiş Altındaş Dept. of Anesthesiology
Regional Anesthesia Fatiş Altındaş Dept. of Anesthesiology Regional anesthesia - Definition Renders a specific area of the body, e.g. foot, arm, lower extremities insensating to stimulus of surgery or
More informationIntraspinal (Neuraxial) Analgesia Community Nurses Competency Test
Intraspinal (Neuraxial) Analgesia Community Nurses Competency Test 1 Intraspinal (Neuraxial) Analgesia for Community Nurses Competency Test 1) Name the two major classifications of pain. i. ii. 2) Neuropathic
More informationPERIOPERATIVE PAIN MANAGEMENT: WHAT S UP WITH METHADONE?
PERIOPERATIVE PAIN MANAGEMENT: WHAT S UP WITH METHADONE? Sandra Z Perkowski, VMD, PhD, DACVAA University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA Pre-emptive and multimodal use
More informationGoals. Epidural anaesthesia. Mechanical ventilation. Cardiopulmonary rescucitation
Goals Epidural anaesthesia Mechanical ventilation Cardiopulmonary rescucitation Why administer an epidural analgesic? Gold standard pain relief for hind limb surgery, single injection lasts for 18-24 hours
More informationRegional Anesthesia. procedure if required. However, many patients prefer to receive sedation either during the
1 Regional Anesthesia Regional anaesthesia (or regional anesthesia) is anesthesia affecting only a large part of the body, such as a limb or the lower half of the body. Regional anaesthetic techniques
More informationRegional Anaesthesia of the Thoracic Limb
Regional Anaesthesia of the Thoracic Limb Trauma and inflammation cause sensitization of the peripheral nervous system and the subsequent barrage of nociceptive input (usually by surgery) produces sensitization
More informationANAESTHESIA FOR LIVER SURGERY
Seminars at 21 Portland Place ANAESTHESIA FOR LIVER SURGERY This seminar is organised in conjunction with the Liver Intensive Care Group of Europe Wednesday 18 th October 2006 Seminars at 21 Portland Place
More informationThe Spinal Cord. The Nervous System. The Spinal Cord. The Spinal Cord 1/2/2016. Continuation of CNS inferior to foramen magnum.
The Nervous System Spinal Cord Continuation of CNS inferior to foramen magnum Simpler than the brain Conducts impulses to and from brain Two way conduction pathway Reflex actions Passes through vertebral
More informationGross Morphology of Spinal Cord
Gross Morphology of Spinal Cord Lecture Objectives Describe the gross anatomical features of the spinal cord. Describe the level of the different spinal segments compared to the level of their respective
More informationMeg Carman DNP, ACNP-BC, ENP-BC, FAEN Melinda Johnson, MSN, FNP-BC, AGACNP-BC, ENP-C. performing lumbar puncture (LP) in the emergency care setting
Lumbar Puncture Meg Carman DNP, ACNP-BC, ENP-BC, FAEN Melinda Johnson, MSN, FNP-BC, AGACNP-BC, ENP-C Objectives 1. Identify indications, contraindications, and considerations for performing lumbar puncture
More informationThe Spinal Cord & Spinal Nerves
The Spinal Cord & Spinal Nerves Together with brain forms the CNS Functions spinal cord reflexes integration (summation of inhibitory and excitatory) nerve impulses highway for upward and downward travel
More informationLumbar cistern is site of lumbar puncture for removal of CSF sample LC contains cauda equina. Anatomical Review
Lumbar Puncture Lumbar cistern is site of lumbar puncture for removal of CSF sample LC contains cauda equina Anatomical Review Anatomical review Overview An LP (lumbar puncture) is an invasive diagnostic
More informationREGIONAL/LOCAL ANESTHESIA and OBESITY
REGIONAL/LOCAL ANESTHESIA and OBESITY Jay B. Brodsky, MD Stanford University School of Medicine Jbrodsky@stanford.edu Potential Advantages Regional compared to General Anesthesia Minimal intra-operative
More informationSpinal Cord Protection. Chapter 13 The Spinal Cord & Spinal Nerves. External Anatomy of Spinal Cord. Structures Covering the Spinal Cord
Spinal Cord Protection Chapter 13 The Spinal Cord & Spinal Nerves We are only going to cover Pages 420-434 and 447 Together with brain forms the CNS Functions spinal cord reflexes integration (summation
More informationGross Morphology of Spinal Cord
Gross Morphology of Spinal Cord Done By : Rahmeh Alsukkar ** I did my best and sorry for any mistake ** the sheet does not contain pictures, tables and some slides so please be careful and go back to slides
More informationChapter 13. The Spinal Cord & Spinal Nerves. Spinal Cord. Spinal Cord Protection. Meninges. Together with brain forms the CNS Functions
Spinal Cord Chapter 13 The Spinal Cord & Spinal Nerves Together with brain forms the CNS Functions spinal cord reflexes integration (summation of inhibitory and excitatory) nerve impulses highway for upward
More informationComparison of Bolus Bupivacaine, Fentanyl, and Mixture of Bupivacaine with Fentanyl in Thoracic Epidural Analgesia for Upper Abdominal Surgery
Original Article DOI: 10.17354/ijss/2016/156 Comparison of Bolus Bupivacaine, Fentanyl, and Mixture of Bupivacaine with Fentanyl in Thoracic Epidural Analgesia for Upper Abdominal Surgery Sachin Gajbhiye
More informationSign up to receive ATOTW weekly -
SPINAL ANAESTHETIC SPREAD ANAESTHESIA TUTORIAL OF THE WEEK 37 28 th NOVEMBER 2006 Dr Graham Hocking Consultant in Anaesthesia and Pain Medicine, John Radcliffe Hospital, Oxford, UK Email: ghocking@btinternet.com
More informationProceedings of the World Small Animal Veterinary Association Sydney, Australia 2007
Proceedings of the World Small Animal Sydney, Australia 2007 Hosted by: Next WSAVA Congress REDUCING THE PAIN FACTOR AN UPDATE ON PERI-OPERATIVE ANALGESIA Sandra Forysth, BVSc DipACVA Institute of Veterinary,
More informationOPUS MEDICAL B.V.B.A. Spoorwegstraat 76 B-3500 Hasselt Belgium Tel.: +32(0)11/ Fax: +32(0)11/
LOCAL REGIONAL http://www.opusmedical.com Spinal Needles Epidural Needles Sets for Continuous Epidural Anesthesia Needles for Combined Spinal-Epidural Anesthesia Sets for Combined Spinal-Epidural Anesthesia
More informationCentral Nervous System: Part 2
Central Nervous System: Part 2 1. Meninges 2. CSF 3. Spinal Cord and Spinal Nerves Explain spinal cord anatomy, including gray and white matter and meninges (give the general functions of this organ).
More informationPerioperative Pain Management
Perioperative Pain Management Overview and Update As defined by the Anesthesiologist's Task Force on Acute Pain Management are from the practice guidelines from the American Society of Anesthesiologists
More informationMODULE 2 Substance Administration and Blood Collection in the Laboratory Rat
LABORATORY ANIMAL BIOMETHODOLOGY WORKSHOP MODULE 2 Substance Administration and Blood Collection in the Laboratory Rat Table of Contents 1. GENERAL INFORMATION... 2 2. SUBSTANCE ADMINISTRATION... 3 3.
More informationPostdural puncture headache preventing the impossible, treating the symptoms, evaluating long term effects.
Postdural puncture headache preventing the impossible, treating the symptoms, evaluating long term effects. Marc Van de Velde, MD, PhD Professor of Anaesthesia, Catholic University Leuven (KUL) Chair Department
More informationThe Team. Regional Anesthesia for Postoperative Pain Management. How Can We Reduce Pain? Understanding the Principles of Pain Process
Regional Anesthesia for Postoperative Pain Management Chris Peltier, DNP, RN-BC, FNP-BC The Team Regional Anesthesia Pain Service (RAPS) University of Minnesota M-Health University of Minnesota Masonic
More informationUsing methadone alongside other opioids. Dr. Jo Murrell BVSc. (hons), PhD, DiplECVAA, MRCVS
Using methadone alongside other opioids Dr. Jo Murrell BVSc. (hons), PhD, DiplECVAA, MRCVS Why might we want to use methadone alongside other opioids? 1. Multi-modal analgesia strategies e.g. using methadone
More informationInterscalene brachial plexus blocks in the management of shoulder dislocations
Archives of Emergency Medicine, 1989, 6, 199-204 Interscalene brachial plexus blocks in the management of shoulder dislocations T. J. UNDERHILL, A. WAN & M. MORRICE Accident and Emergency Department, Derbyshire
More informationASA Closed Claims Project: Regional Anesthesia Claims 1990 or later Lorri A. Lee MD Department of Anesthesiology University of Washington, Seattle, WA
ASA Closed Claims Project: Regional Anesthesia Claims 1990 or later Lorri A. Lee MD Department of Anesthesiology, Seattle, WA OVERVIEW 1. Closed Claims Project 2. Peripheral Nerve Blocks 3. Neuraxial Claims
More informationCOMBINED SPINAL EPIDURAL ANAESTHESIA TECHNIQUE IN OBSTETRICS
COMBINED SPINAL EPIDURAL ANAESTHESIA TECHNIQUE IN OBSTETRICS Andre Van Zundert Catharina Hospital Eindhoven The Netherlands Introduction The combined spinal-epidural anesthesia technique (CSE) has been
More informationPATIENT CARE MANUAL POLICY
PATIENT CARE MANUAL POLICY NUMBER VII-A-15 PAGE 1 OF 3 APPROVED BY: CATEGORY: Vice President and Senior Operating Officer; Rural Health Services & Professional Practice Lead Body Systems; Central Nervous
More informationCombined spinalepidural. epidural analgesia in labour (review) By Neda Taghizadeh
Combined spinalepidural versus epidural analgesia in labour (review) By Neda Taghizadeh Cochrane review Cochrane collaboration was founded in 1993 and is named after Archie Cochrane (1909-1988), British
More informationCHALLENGES OF PERIOPERATIVE FELINE PAIN MANAGEMENT
CHALLENGES OF PERIOPERATIVE FELINE PAIN MANAGEMENT Alicia Z Karas DVM, DACVA Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA There are a number of factors that make cats different
More informationOverview. Spinal Anatomy Spaces & Meninges Spinal Cord. Anatomy of the dura. Anatomy of the arachnoid. Anatomy of the spinal meninges
European Course in Neuroradiology Module 1 - Anatomy and Embryology Dubrovnik, October 2018 Spinal Anatomy Spaces & Meninges Spinal Cord Johan Van Goethem Overview spinal meninges & spaces spinal cord
More informationLabor Epidural: Local Anesthetics and Beyond
Goals: Labor Epidural: Local Anesthetics and Beyond Pedram Aleshi MD The Changing Practice of Anesthesia September 2012 Review Concept of MLAC Local anesthetic efficacy Local anesthetic sparing effects:
More informationVAN WERT COUNTY HOSPITAL. Policy/Procedure: Departmental No.: N 11-36A. Issue Date: 7-97 By: Nursing No. of Pages: 6
VAN WERT COUNTY HOSPITAL Policy/Procedure: Departmental No.: N 11-36A Issue Date: 7-97 By: Nursing No. of Pages: 6 Reviewed: 9-14, 8-11, 8-10 Revised: 9-14 Distribution List: All Nursing Departments Concurrence:
More informationEvaluation of the Effect of Magnesium Sulphate as Adjunct to Epidural Bupivacaine: An Institutional Based Study
Original article: Evaluation of the Effect of Magnesium Sulphate as Adjunct to Epidural Bupivacaine: An Institutional Based Study RajulSubhash Karmakar 1, ShishirRamachandra Sonkusale 1* 1Associate Professor,
More informationNeural Blocks in Pain Medicine D R M A R G A R E T E B O N E M B C H B F R C A F F P M R C A C O N S U LTA N T I N PA I N M E D I C I N E
Neural Blocks in Pain Medicine D R M A R G A R E T E B O N E M B C H B F R C A F F P M R C A C O N S U LTA N T I N PA I N M E D I C I N E Stellate Ganglion Block Lumbar Sympathetic Block Requirements Diagnosis
More informationLOCAL ANESTHETIC NERVE BLOCKS and ANALGESIA. Carolyn Cartwright, RVT, VTS (Anesthesia/Analgesia)
LOCAL ANESTHETIC NERVE BLOCKS and ANALGESIA Carolyn Cartwright, RVT, VTS (Anesthesia/Analgesia) Effective approach for optimum pain management requires a practical multimodal anesthesia and analgesia protocol.
More informationContinuous Spinal Anaesthesia
Continuous Spinal Anaesthesia Ph. Biboulet Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier France CSA story : 1906 Dean 1944 Tuohy 1991 CSA revisited
More informationSTANDARDIZED PROCEDURE NEONATAL LUMBAR PUNCTURE (Neonatal)
I. Definition The lumbar puncture is used to sample the cerebral spinal fluid (CSF) to determine if an infection exists, to diagnose certain disease states, or (with order of Attending/Fellow) to drain
More informationSPINAL CORD DISEASE IN DOGS PART TWO: MOST LIKELY CAUSES
Vet Times The website for the veterinary profession https://www.vettimes.co.uk SPINAL CORD DISEASE IN DOGS PART TWO: MOST LIKELY CAUSES Author : RITA GONÇALVES Categories : Vets Date : April 7, 2014 RITA
More informationCHANGES IN INTRACRANIAL PRESSURE ASSOCIATED WITH EXTRADURAL ANAESTHESIA
Br. J. Anaesth. (1986), 58, 676680 CHANGES IN INTRACRANIAL PRESSURE ASSOCIATED WITH EXTRADURAL ANAESTHESIA H. HILT, H.J. GRAMM AND J. LINK Extradural blockade is commonly used in our clinic to provide
More informationRadiography of the Spine
Radiography of the Spine Radiography of the Spine Attila ARANY-TóTH, DVM Complex anatomy Vertebrae: 7 cervical, 13 thoracal, 7 lumbal, 3 sacral, n caudal Thorough neurological examination - localization!!!
More informationAnalgesia for Small Animals Pharmacology & Clinical Practice. Jill Maddison The Royal Veterinary College Hawkshead Lane, North Mymms, AL9 7TA, UK
Analgesia for Small Animals Pharmacology & Clinical Practice Jill Maddison The Royal Veterinary College Hawkshead Lane, North Mymms, AL9 7TA, UK Colin Dunlop Advanced Anaesthesia Specialists Unit 13, 46-48
More informationCONTINUOUS SPINAL. Prof. Dr. Armando Fortuna, TSA
CONTINUOUS SPINAL Prof. Dr. Armando Fortuna, TSA CONTINUOUS SPINAL History: Dean, 1907, needle. Lemmon, 1940, malleable needle. Tuohy, 1944, Rubber Uretheral catheter, 15G needle. Hingson and al: polyethylene,
More informationLocal anaesthetics. Dr JM Dippenaar
Local anaesthetics Dr JM Dippenaar Chemical structure Lipophilic phenol ring + Amide/Ester bridge + Hydrophilic chain Local anesthetic drugs Amides Esters Lignocaine Cocaine Bupivacaine PABA esters Ropivacaine
More informationA Patient s Guide to Pain Management: Pain Pumps
A Patient s Guide to Pain Management: Pain Pumps 2350 Royal Boulevard Suite 200 Elgin, IL 60123 Phone: 847.931.5300 Fax: 847.931.9072 DISCLAIMER: The information in this booklet is compiled from a variety
More informationNON-OPIOID ANALGESIA & THE IMPLICATIONS OF ANESTHETIC DRUGS IN THE PERI-ANESTHETIC ARENA AMANDA AFFLECK CRNA
NON-OPIOID ANALGESIA & THE IMPLICATIONS OF ANESTHETIC DRUGS IN THE PERI-ANESTHETIC ARENA AMANDA AFFLECK CRNA OR, ANESTHESIA, WHY DO THEY DO THAT? OUTLINE Neurotransmission of pain Arachidonic Acid pathway
More informationConfirmation with Epidurogram Necessary?
Use of Fluoroscopy for Interlaminar Lumbar Epidural Injection: Is Confirmation with Epidurogram Necessary? Saeid Alemo, MD Department of Neurosurgery,Drexel University College of Medicine, Philadelphia,Pennsylvania
More informationTHE BACK THE SPINAL CORD
THE BACK THE SPINAL CORD The structures in the vertebral canal: the spinal cord spinal nerve roots spinal meninges the neurovascular structures THE SPINAL CORD The spinal cord occupies the superior 2/3
More information01/2006, Vidacare Corporation, all rights reserved. Vidacare, EZ-IO Product System and EZ-Connect are trademarks of the Vidacare Corporation.
Intraosseous Infusion System Directions for Use 01/2006, Vidacare Corporation, all rights reserved. Vidacare, EZ-IO Product System and EZ-Connect are trademarks of the Vidacare Corporation. EC REP Emerge
More informationIndia) 4 (Assistant Professor, Department Of Anaesthesiology, Seth G. S. Medical College & K.E.M. Hospital, India)
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-086.Volume 5, Issue 8 Ver. X (August. 206), PP 86-92 www.iosrjournals.org Comparative Study of the Localisation of
More informationAwake regional versus general anesthesia in preterms and ex-preterm infants for herniotomy
Awake regional versus general anesthesia in preterms and ex-preterm infants for herniotomy Department of Anaesthesia University Children s Hospital Zurich Switzerland Epidemiology Herniotomy needed in
More informationAnalgesia. The modern approach. Dr. Mark Haworth MB.ChB.DA.MRCA.
Analgesia The modern approach Dr. Mark Haworth MB.ChB.DA.MRCA. What is pain? An unpleasant sensory and emotional experience associated with actual or potential tissue damage. (Melzac and Wall) How is pain
More informationVERTEBRAL COLUMN ANATOMY IN CNS COURSE
VERTEBRAL COLUMN ANATOMY IN CNS COURSE Vertebral body Sections of the spine Atlas (C1) Axis (C2) What type of joint is formed between atlas and axis? Pivot joint What name is given to a fracture of both
More informationSarah Reece-Stremtan M.D. Peripheral Nerve Blockade Neuraxial Blocks
Neuraxial Anesthesia Sarah Reece-Stremtan M.D. Regional Anesthesia Peripheral Nerve Blockade Neuraxial Blocks Placed in the OR under general anesthesia by members of the regional anesthesia team 1 Sensory
More informationSign up to receive ATOTW weekly
PERIPHERAL NERVE BLOCKS GETTING STARTED ANAESTHESIA TUTORIAL OF THE WEEK 134 PUBLICATION DATE 18/05/09 Dr Kim Russon, Consultant Anaesthetist Dr Helen Findley, ST3 Anaesthetics Dr Zoe Harclerode, ST3 Anaesthetics
More informationSURGICAL NEURAXIAL ANALGESIA/ANESTHESIA EPIDURAL/PARAVERTEBRAL/ INTRATHECAL/PERIPHERAL REGIONAL, INTERMITTENT OR CONTINUOUS
KINGSTON GENERAL HOSPITAL SURGICAL NEURAXIAL ANALGESIA/ANESTHESIA: EPIDURAL/PARAVERTEBRAL/ INTRATHECAL/PERIPHERAL REGIONAL, INTERMITTENT OR CONTINUOUS ANALGESIA/ANESTHESIA LEARNING GUIDE Prepared by: Nursing
More informationResearch and Reviews: Journal of Medical and Health Sciences
Research and Reviews: Journal of Medical and Health Sciences Evaluation of Epidural Clonidine for Postoperative Pain Relief. Mukesh I Shukla, Ajay Rathod, Swathi N*, Jayesh Kamat, Pramod Sarwa, and Vishal
More informationScript for: Regional Anesthesia Surgery 101 Podcast Department of Surgery University of Alberta. Urooj Siddiqui Med 4 University of Alberta
Script for: Regional Anesthesia Surgery 101 Podcast Department of Surgery University of Alberta By Urooj Siddiqui Med 4 University of Alberta Hello, and welcome back to Surgery 101. My name is Urooj Siddiqui,
More informationDr L. Delaunay Clinique Générale Annecy Vivalto Santé. With the complicity of : C Aveline, O Choquet, JP Estèbe, P Zetlaoui
Dr L. Delaunay Clinique Générale Annecy Vivalto Santé With the complicity of : C Aveline, O Choquet, JP Estèbe, P Zetlaoui Successful spinal anesthesia? Puncture success => CSF back flow No pain, No paresthesia
More informationSpine Pain Management Program
Spine Pain Management Program Please complete the following information: Patient Name: Patient ID Number: Patient DOB: The procedure being requested: Epidural Injection Please check the indication (reason)
More informationANATOMY OF THE SPINAL CORD. Structure of the spinal cord Tracts of the spinal cord Spinal cord syndromes
SPINAL CORD ANATOMY OF THE SPINAL CORD Structure of the spinal cord Tracts of the spinal cord Spinal cord syndromes The Nervous System Coordinates the activity of muscles, organs, senses, and actions Made
More informationANESTHESIA EXAM (four week rotation)
SPARROW HEALTH SYSTEM ANESTHESIA SERVICES ANESTHESIA EXAM (four week rotation) Circle the best answer 1. During spontaneous breathing, volatile anesthetics A. Increase tidal volume and decrease respiratory
More informationGeneral Anesthesia. My goal in general anesthesia is to stop all of these in the picture above (motor reflexes, pain and autonomic reflexes).
General Anesthesia General anesthesia is essential to surgical practice, because it renders patients analgesic, amnesia and unconscious reflexes, while causing muscle relaxation and suppression of undesirable
More informationANESTHESIA FOR CESAREAN DELIVERY
REVIEW ARTICLE ANESTHESIA FOR CESAREAN DELIVERY Naitik Patel Assistant Professor, Department of Anesthesia, Gujarat Adani Institute of Medical Science, Bhuj, Gujarat. ABSTRACT: Anesthetic techniques currently
More informationParaspinal Blocks a new paradigm in truncal analgesia
Paraspinal Blocks a new paradigm in truncal analgesia Ki Jinn Chin, MBBS (Hons), MMed, FRCPC Associate Professor Toronto Western Hospital University of Toronto Online Resources https://youtu.be/lockhd
More informationSpinal Cord H. Ruth Clemo, Ph.D.
Spinal Cord H. Ruth Clemo, Ph.D. OBJECTIVES After studying the material of this lecture, the student should be familiar with: 1. Surface anatomy of the spinal cord. 2. Internal structure and organization
More informationNursing the spinal patient
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Nursing the spinal patient Author : Lisa Thompson Categories : RVNs Date : November 1, 2009 Lisa Thompson DipAVN(surg), looks
More informationDURAL PUNCTURE EPIDURAL ANALGESIA IS NOT SUPERIOR TO CONTINUOUS LABOR EPIDURAL ANALGESIA
DURAL PUNCTURE EPIDURAL ANALGESIA IS NOT SUPERIOR TO CONTINUOUS LABOR EPIDURAL ANALGESIA Deepak Gupta *, Arvind Srirajakalidindi *, Vitaly Soskin ** Abstract Background: Some anesthesiologists consider
More informationCOMBINED SPINAL AND EPIDURAL ANAESTHESIA (CSEA) USING SEPARATE INTERSPACE TECHNIQUE
COMBINED SPINAL AND EPIDURAL ANAESHESIA (CSEA) USING SEPARAE INERSPACE ECHNIQUE Shreepathi Krishna Achar* 1, Vinoda Venkata Rao Assistant Professor, Department of Anaesthesiology, Kasturba Medical College,
More informationProceedings of the 55th Annual Convention of the American Association of Equine Practitioners
Close this window to return to IVIS www.ivis.org Proceedings of the 55th Annual Convention of the American Association of Equine Practitioners December 5 9, 2009, Las Vegas, Nevada Program Chair : Nathaniel
More informationSurgery. Conus medullaris and Cauda Equina Syndromes. Anatomy. See online here
Surgery Conus medullaris and Cauda Equina Syndromes See online here Conus medullaris and cauda equina syndromes are spinal cord injuries that involve injury to the lumbosacral segment of the spinal cord.
More informationPost-Anesthesia Care In the ICU
Post-Anesthesia Care In the ICU The following is based on current research and regional standards of care. At completion you will be able to identify Basic equipment needed at the bedside. Aldrete scoring
More informationC A S E R E P O R T Tutorial 378
C A S E R E P O R T Tutorial 378 Broken spinal needle Anne Moll 1 and Gertie Filippini 2 1 Resident anaesthetist, Radboudumc, the Netherlands 2 Consultant anaesthetist, Bernhoven, the Netherlands Edited
More informationCentral Venous Line Insertion
Central Venous Line Insertion Understand the indications and risks of CVC insertion Understand and troubleshoot the seldinger technique Understand available sites and select the appropriate site for clinical
More informationEAST MULTICENTER STUDY DATA COLLECTION TOOL
EAST MULTICENTER STUDY DATA COLLECTION TOOL Multicenter Study: Effect of Regional Anesthesia on Delirium in Geriatric Trauma Patients with Multiple Rib Fractures Enrolling Center: Enrolling Co-investigators:
More informationEspocan. Enhance technique and reduce risk with leading-edge technology. Combined Spinal/Epidural Needle Technology Innovative
Espocan Enhance technique and reduce risk with leading-edge technology Combined Spinal/Epidural Needle Technology B. for CSE Innovative procedures Why partner with B. Braun? Confidence and Security of
More informationChapter 8 Nervous System
Chapter 8 Nervous System Two message centers: Functions of these systems: 1. * 2. * Overview of the Nervous System Parts: General Functions: Functions Sensory input: Sensation via nerves Integration: interpretation
More informationCeliac plexus block. Dr.Kasturi Bhagawati Asst.professor Dept. of Emergency Medicine & Critical care.
Celiac plexus block Dr.Kasturi Bhagawati Asst.professor Dept. of Emergency Medicine & Critical care. Introduction A celiac plexus block is an injection of local anesthetic into or around the celiac plexus
More informationCentral Nervous System - Brain & Cranial Nerves. Chapter 14 Part A
Central Nervous System - Brain & Cranial Nerves Chapter 14 Part A Central Nervous System Central nervous system (CNS) is responsible for: Receiving impulses from receptors Integrating information Sending
More informationDistribution of Bupivacaine in Epidural Space
Original Article Distribution of Bupivacaine in Epidural Space Hamid Haji Gholam Saryazdi 1, Gholamreza khalili 1, Reihanak Talakoub 1*, Masoud Shahbazi 1, Saeed Abbasi 1 Abstract Background: There is
More informationPost-Dural Puncture Headache. Dr. Jacobs Aurélie Krans Anesthesie 18/03/2016 Kliniek St.-Jan, Brussel
Post-Dural Puncture Headache Dr. Jacobs Aurélie Krans Anesthesie 18/03/2016 Kliniek St.-Jan, Brussel I - PATHOPHYSIOLOGY August Bier (intrathecal cocaïn1898)! first 2 cases PDPH CSF leak trough dura mater
More informationDr L. Delaunay Clinique Générale Annecy Vivalto Santé. With the complicity of : C Aveline, O Choquet, JP Estèbe, P Zetlaoui
Dr L. Delaunay Clinique Générale Annecy Vivalto Santé With the complicity of : C Aveline, O Choquet, JP Estèbe, P Zetlaoui Successful spinal anesthesia? Puncture success => CSF back flow No pain, No paresthesia
More informationDefinitions and terminology. Principles of management
Definitions and terminology Department of Anaesthesia University of Cape Town Regional Anaesthesia Regional anaesthesia affects one part of the body only, such as a limb, versus general anaesthesia, where
More informationSpinal Analgesia (Neuraxial analgesia in humans)
Spinal Analgesia (Neuraxial analgesia in humans) Paul Farquhar-Smith The Royal Marsden NHS Foundation Trust And other humanoid species Neuraxial analgesia Cancer pain ADDITIONAL ANALGESIC MEASURES FINAL
More informationPresentation Menu. Walk-in Slide. Full Presentation. Access. Site. Needle. Flush. Comfort. Monitor. Removing the EZ-IO catheter.
Presentation Menu Walk-in Slide Full Presentation Access Site Needle Flush Comfort Monitor Removing the EZ-IO catheter Clinical Support Explore. Discover. Examine. Vidacare Workshop Programmes www.vidacare.com
More informationGUIDELINES FOR PERIPHERAL NERVE / PLEXUS BLOCK CATHETER MANAGEMENT DEPARTMENT OF ANAESTHESIOLOGY AND INTENSIVE CARE HOSPITAL KUALA LUMPUR
GUIDELINES FOR PERIPHERAL NERVE / PLEXUS BLOCK CATHETER MANAGEMENT DEPARTMENT OF ANAESTHESIOLOGY AND INTENSIVE CARE HOSPITAL KUALA LUMPUR INTRODUCTION Regional block provides superior pain relief, compared
More informationSpinal Cord Injuries: The Basics. Kadre Sneddon POS Rounds October 1, 2003
Spinal Cord Injuries: The Basics Kadre Sneddon POS Rounds October 1, 2003 Anatomy Dorsal columntouch, vibration Corticospinal tract- UMN Anterior horn-lmn Spinothalamic tractpain, temperature (contralateral)
More informationCentral Nervous System (CNS) -> brain and spinal cord. Major Divisions of the nervous system:
Central Nervous System (CNS) -> brain and spinal cord Major Divisions of the nervous system: Afferent (sensory input) -> cell bodies outside of the central nervous system (CNS), carry info into the CNS
More informationDr P.W.Buczkowski. Consultant in Anaesthesia & Pain Medicine. Royal Derby Hospital
Dr P.W.Buczkowski Consultant in Anaesthesia & Pain Medicine Royal Derby Hospital INTERVENTIONAL PAIN MANAGEMENT III Neuroaxial Drug Delivery KYIV May 2010 Dr J Azzopardi MD FRCA FFPMANZCA FFPMRCA Consultant
More informationSOP: Urinary Catheter in Dogs and Cats
SOP: Urinary Catheter in Dogs and Cats These SOPs were developed by the Office of the University Veterinarian and reviewed by Virginia Tech IACUC to provide a reference and guidance to investigators during
More informationMODULE 2 THE LABORATORY RAT
University Animal Care Committee LABORATORY ANIMAL BIOMETHODOLOGY WORKSHOP MODULE 2 THE LABORATORY RAT SUBSTANCE ADMINISTRATION AND BLOOD COLLECTION Substance Administration: Subcutaneous injection Intramuscular
More informationComparison of fentanyl versus fentanyl plus magnesium as post-operative epidural analgesia in orthopedic hip surgeries
Original Research Article Comparison of fentanyl versus fentanyl plus magnesium as post-operative epidural analgesia in orthopedic hip surgeries P V Praveen Kumar 1*, Sreemanth 2 1 Associate Professor,
More information