Key Points • Neuraxial analgesia/anesthesia (spinal, epidural, combined spinal-epidural) are mainstays of safe anesthesia care of the obstetric patient. The anesthesia provider is caring for the mother, and by extension,…
Key Points • Prepuncture ultrasound scanning is helpful to determine the midline, the depth from the skin, the desired level, and rotation of the spine. • There are limited outcome…
Key Points • Performing this block requires ultrasound experience. • Needle visualization plays a major role in achieving a successful block. • Epidural spread can occur from a unilateral injection….
Key Points • Patient selection plays a major role in performing the block; it is challenging with obese patients. • Ultrasound experience is required to maximize the success rate of…
Key Points • Stabilize the neck position, and identify the sternocleidomastoid muscle. • If not using the ultrasound, always feel for the infiltration with the other hand to avoid injecting…
Key Points • Identifying the different layers of the muscles is crucial because the peritoneum is the shiniest layer under the transversus abdominis muscle. When the bowels are seen under…
Key Points • In approximately 5% of adult patients, the sacral hiatus is nearly impossible to cannulate with needle or catheter. • The tissue mass overlying the sacrum in some…
Key Points • Checking the anatomy with ultrasound before and during the procedure assures success. Because the sacrum is not fully ossified, it can still be penetrated by the ultrasound…
Key Points • Epidural block can be performed in cervical, thoracic, and lumbar regions of the vertebral column. • Paramedian approach is the preferred technique for thoracic epidural, while median…
Key Points • Spinal anesthesia is unparalleled in that a small mass of local anesthetic can produce dense surgical anesthesia. • Bupivacaine is the ideal drug for spinal anesthesia. •…
