Intraoperative Considerations: Regional and Neuraxial Anesthesia - FREE NO CME-Intraoperative Considerations - Regional and Neuraxial Anesthesia (Video)

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Video Summary

The presentation provides a comprehensive overview of regional neuraxial anesthesia and analgesia, focusing on spinal, epidural, and combined spinal-epidural (CSE) techniques. Spinal anesthesia involves injecting local anesthetics into the subarachnoid space, providing rapid-onset, dense sensory and motor block commonly used for lower body surgeries. Key considerations include contraindications such as infection, coagulopathy, and potential hemodynamic instability from sympathectomy. Epidural anesthesia, delivered into the epidural space, has a slower onset and less dramatic hypotension but allows continuous dosing via a catheter, often used for thoracic, obstetric, and postoperative pain management. The CSE technique combines benefits of both. Monitoring involves blood pressure, sensory block level, and respiratory status, especially due to risks like hypotension, bradycardia, urinary retention, and rare but serious complications like hematoma or spinal cord injury.<br /><br />The lecture also covers peripheral regional anesthesia techniques using ultrasound guidance for targeted nerve blocks, which reduce opioid use, improve pain control, and decrease postoperative complications across various surgeries. Awareness of complications like local anesthetic systemic toxicity and management protocols including lipid emulsion therapy were emphasized. The talk highlighted collaboration between anesthesia and surgical teams to safely implement regional anesthesia programs, with resources such as NYSORA available for training. Regional anesthesia plays a vital role in multimodal analgesia and improved surgical recovery.

Keywords

regional neuraxial anesthesia

spinal anesthesia

epidural anesthesia

combined spinal-epidural (CSE)

peripheral nerve blocks

ultrasound-guided anesthesia

local anesthetic systemic toxicity

multimodal analgesia