Spinal Anesthesia Mnemonic
"Little Boys Prefer Toys":
Lidocaine
Bupivacaine
Procaine
Tetracaine
Here are some spinal anesthesia key points to review for the board exam:
Mechanism of Action:
Spinal anesthesia involves the injection of local anesthetic into the cerebrospinal fluid (CSF) in the subarachnoid space, leading to temporary interruption of nerve transmission.
Common Agents:
- Lidocaine: Rapid onset, short duration.
- Bupivacaine: Longer duration, more potent.
- Tetracaine: Long duration, used for longer procedures.
- Procaine: Short duration, less commonly used.
Physiological Effects:
- Cardiovascular: Can cause hypotension due to sympathetic blockade.
- Respiratory: High spinal blocks can affect respiratory muscles.
- Neurological: Provides sensory, motor, and autonomic blockade.
Indications:
- Suitable for surgeries involving the lower abdomen, pelvis, and lower extremities.
- Commonly used in obstetrics for cesarean sections.
Contraindications:
Patient refusal, infection at the injection site, severe hypovolemia, increased intracranial pressure, and coagulopathy.
Complications:
- Hypotension: Due to sympathetic blockade.
- Post-dural puncture headache: Caused by CSF leakage.
- Neurological injury: Rare but serious.
- Infection: Meningitis or abscess formation.
Advantages:
- Provides excellent analgesia and muscle relaxation.
- Reduces the need for systemic opioids.
- Allows the patient to remain awake and alert.
Disadvantages:
- Risk of hypotension and bradycardia.
- Limited duration of action.
- Potential for post-dural puncture headache.
For more anesthesiology mnemonics check this mnemonic book.
This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services or your primary care provider. Please refer to your doctor for medical advice.