4 Tips for successful spinal anesthesia

1-Decide on the highest level of innervation that will need to be blocked for the proposed surgery remembering that the underlying organs and peritoneum may come from higher spinal segments .

2-Check for lower limb weakness as an early indicator that the injection was correct. Inability to straight leg raise suggests the block will cover at least all the lumbar segments .

3-Cold can be used but will usually demonstrate blocked segments higher than those with surgical anaesthesia. Pinprick will generally be closer to the level of surgical anaesthesia .

4-To be completely happy that surgery can be performed painlessly it is wise to ensure that the level of testing to cold or pinprick is at least 2-3 segments higher than that needed. This will provide a margin for error and also ensure that the operative site does not regain sensation too quickly.

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The pressure volume loop...

In the pressure-volume loop below, cardiac work is best represented by: the area of the curve the slope of the line from points C to D the distance of the line from points C to D the slope of a line from points A to D .. .. ... .... ... .... .... .... In the pressure-volume loop below, cardiac work is best represented by: the area of the curve Cardiac work is the product of pressure and volume and is linearly related to myocardial oxygen consumption. Cardiac work is best represented by the area of the curve of a pressure-volume loop.

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