Intraoperative Considerations: Regional and Neuraxial Anesthesia - CME Paid Option-Intraoperative Considerations - Regional and Neuraxial Anesthesia (Video)

Video Transcription

Video Summary

This comprehensive lecture covers regional and neuraxial anesthesia techniques, focusing on spinal, epidural, and combined spinal-epidural (CSE) anesthesia, along with peripheral nerve blocks. Spinal anesthesia involves injecting local anesthetics into the subarachnoid space, providing rapid, dense blocks commonly used for lower abdominal, pelvic, and lower extremity surgeries. It's effective but limited by duration and risks like hypotension and potential neurologic injury. Epidural anesthesia, administered into the epidural space, has slower onset but allows continuous dosing, useful intra- and post-operatively for pain control, with fewer hemodynamic effects. CSE combines both for rapid onset and prolonged analgesia.<br /><br />The discussion includes additives like clonidine and epinephrine that prolong block duration and outlines contraindications such as infection, coagulopathy, and certain cardiac or spinal conditions. Monitoring protocols emphasize blood pressure, respiratory status, and neurologic assessment to identify complications like high spinal block, hematoma, or local anesthetic systemic toxicity.<br /><br />Peripheral nerve blocks, guided by ultrasound, target specific nerves to provide opioid-sparing analgesia in various surgeries. Examples include interscalene, suprascapular, adductor canal, and transverse abdominis plane blocks. Benefits include reduced postoperative complications, faster recovery, and decreased chronic pain incidence. The talk highlights the importance of multidisciplinary collaboration and education to implement and optimize these techniques in clinical practice effectively.

Keywords

regional anesthesia

neuraxial anesthesia

spinal anesthesia

epidural anesthesia

combined spinal-epidural (CSE) anesthesia

peripheral nerve blocks

ultrasound-guided nerve blocks

anesthesia complications and monitoring