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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

574
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
574
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

408
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
408
General Anesthesia: Overview01:24

General Anesthesia: Overview

190
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
190
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

352
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
352
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

386
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
386
Stages of General Anesthesia01:22

Stages of General Anesthesia

355
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
355

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Related Experiment Video

Updated: Jun 1, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

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Failed Spinal Anesthesia: Incidence and Associated Factors.

Aparna Bagle1, Shweta Khatri1, Runjhun Jain1

  • 1Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

Cureus
|January 21, 2025
PubMed
Summary

Spinal anesthesia failure occurred in 1.83% of cases, with total failures more common. Practitioner experience significantly impacts success rates, highlighting the need for enhanced training in anesthetic techniques.

Keywords:
failed spinal anesthesiaincidence ratepatient positionspinal anesthesiasubarachnoid space

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Area of Science:

  • Anesthesiology
  • Surgical Safety
  • Clinical Outcomes

Background:

  • Spinal anesthesia is a common technique for various surgeries, but its failure can lead to adverse patient outcomes.
  • The incidence of spinal anesthesia failure varies widely (1-17%) due to technical, anatomical, and experience-related factors.
  • Understanding the specific incidence and causes of failure in a university hospital setting is crucial for improving patient care.

Purpose of the Study:

  • To determine the incidence of spinal anesthesia failure.
  • To identify the primary causes and contributing factors of spinal anesthesia failure.
  • To analyze the impact of surgical type, urgency, and practitioner experience on spinal anesthesia failure rates.

Main Methods:

  • A prospective observational study involving 3933 patients undergoing spinal anesthesia at a university hospital.
  • Data collection included patient demographics, surgical details, and anesthetic techniques.
  • Failed spinal anesthesia was classified as total or partial, with statistical analysis to identify contributing factors.

Main Results:

  • The overall incidence of spinal anesthesia failure was 1.83% (72 out of 3933 patients).
  • Total failures (87.5%) were more frequent than partial failures (12.5%).
  • Higher failure rates were observed in obstetric (37.5%), orthopedic (25%), and general surgeries (22.22%), with orthopedic surgery showing the highest rate (3.46%). Emergency surgeries (3.87%) had higher failure rates than elective surgeries (1.39%). First-year residents exhibited a significantly higher failure rate (43.06%) compared to experienced practitioners.

Conclusions:

  • The incidence of spinal anesthesia failure in this study was 1.83%, with total failures predominating.
  • Surgical type, emergency status, and practitioner experience are significant factors influencing spinal anesthesia failure.
  • Enhanced training and continuous monitoring of anesthetic techniques are essential for improving patient safety and optimizing outcomes in spinal anesthesia.