Neuraxial Anesthesia - University of Colorado Denver
Recommend Documents
Mountain region; we have seven guitar instructors ... thrilled to be a part of the
faculty of the Guitar Week at the ..... Joe is a very advanced thinker on the guitar.
Scientific Name: Matricaria recutita, once it has been called as Marticaria ...
Common names: German chamomile, Roman chamomile, English chamomile,.
What is the impact of advanced primary care nursing roles on ... nursing roles, particularly first contact nursing roles, for patients, nurses themselves and their colleagues in order to .... used established methods (Centre for Reviews and.
Overall, 36.9% of Colorado high school students tried marijuana one or more ... past 30 days reported driving one or mor
Apr 8, 2014 - Andy Schlichting. Sports Information Director, Metropolitan State University of Denver ... Course: Busines
doses of local anesthetics used to produce spinal anesthesia are devoid of direct
systemic ... anesthesia on him , and his successful spinal on Hildebrandt.
international expert on child welfare and care and protection ..... in a child maltreatment scandal which haunts all ...... participation in FGDM, Beecher, Cash,.
Surgical Techniques and Technology. Chapter 19 ... arthroplasty technology. In Davis ... Finn MA, Samuelson MS, Bishop F
management systems (KMS) which use state-of-the-art technology to facilitate the collection, storage, and distribution o
Nov 20, 2015 - 3 OmniUpdate. 11. 4 Hannon Hill Cascade Server. 10. 5 Custom. 5. 6 SharePoint. 4. CU Denver. 7 Adobe Expe
including automotive, appliance, ... tradition of excellence with a new vision for higher education ... online. We confer more than 3,900 degrees each year and.
Sep 4, 2013 ... Workbook/Laboratory Manual. Volume 9, V.1 ... **You still need to get the
Supplementary Materials book as well. ... Workbook Destinos 20 & 21.
Focus on basic percussion techniques and introductory ensemble playing
utilizing Afro-Cuban literature. Comprised of percussion instruments of both
definite and indefinite ... Musical styles include: jazz, Latin, bluegrass, .... A
comprehensive gu
The online version of this article can be found at: Published .... With their exclusive attention to business schools, previous characterizations of CME in national.
E-mail address: [email protected] (S.E. Wolf). available at ..... with only measurement of red cell mass, plasma volume, ..... Perhaps this is best.
Neuraxial Anesthesia - University of Colorado Denver
Lecture Objectives. Discuss considerations of spinal vs epidural anesthesia.
Review the anatomy. Understand mechanisms of action. Review physiologic
effects.
Neuraxial Anesthesia Prepared by: Brenda A. Bucklin, M.D. Professor of Anesthesiology University of Colorado Denver Health Sciences Center
Lecture Objectives Discuss considerations of spinal vs epidural anesthesia Review the anatomy Understand mechanisms of action Review physiologic effects Review complications Sterile technique
Spinal vs Epidural: How do we decide? Length of procedure Need for prolonged post-op analgesia? Comorbidities
Indications Surgical anesthesia Analgesia
Surgical Anesthesia
Lower abdominal OB/GYN Lower limb Perineal and rectal
A line drawn between the iliac crests crosses the 4th lumbar vertebra
Spinal Ligaments 1. 2. 3.
supraspinous interspinous ligamentum flavum
Lumbosacral Spine
Needle Directions
Needle Directions
Needle Directions
Mechanisms
Mechanism of Spinal Anesthesia Blockade of nerve roots -afferent impulses entering CNS via dorsal roots -efferent impulses leaving CNS via ventral roots
Major Factors Affecting Spinal Anesthetic Level
Baricity Dose Patient position
Distribution of Spinal Anesthetics
Spinal Needle Tips
Why use a pencil point or a cutting spinal needle?
Mechanism of Epidural Anesthesia Diffusion to neural structures
-through dura to CSF -from CSF to spinal cord -from dural root sleeves to nerve roots and spinal cord -from dural root sleeves to spinal nerves
Major Determinant of Block Height
Volume of local anesthetic
Epidural Anesthesia
Epidural: Choice of Local Anesthetic
Local Anesthetics
Physiologic Effects
Respiratory Effects Expiratory function reduced in proportion to anesthetic level Inspiratory function unchanged (diaphragm innervated by cervical plexus)
Cardiovascular Effects Hypotension -related to sympathetic blockade
• Bradycardia
-blockade of cardioaccelerator fibers (T1-T4) decreased outflow from right atrial chronotropic stretch receptors
Cardiovascular Changes During Spinal Anesthesia at Different Segmental Levels
Changes in Various Hemodynamic Parameters as a Function of Epidural Anesthetic Level and Patient Position
Dermatomes
Gastrointestinal Function Hyperperistalsis resulting in nausea/vomiting Decreased hepatic blood flow
ASRA Guidelines •Neuraxial infection is rare but underreported. •Handwashing reduces cross-contamination. •Removing jewelry is prudent. •Surgical masks reduce site contamination. •Chlorhexidine solutions are the antiseptic of choice.
![Mechanical Engineering - University of Colorado Denver [PDF]](https://m.moam.info/img/260x300/mechanical-engineering-university-of-colorado-denv_64892e2c098a9efb118b4567.jpg)
