Anesthesia Techniques

Spinal Anesthesia

  • Definition: Injection of small amounts (2-3 ml) of local anesthetics into the CSF at the level below L2, achieving anesthesia of the lower body part below the umbilicus.
  • Indications: Operations below the umbilicus, such as hernia repairs, gynecological, urological operations, orthopedics, or any operation on the perineum or genitalia.

Contraindications

  • Refusal
  • Infection
  • Coagulopathy & anticoagulated patients
  • Severe hypovolemia
  • Increased intracranial pressure
  • Severe aortic or mitral stenosis

Techniques

  • Midline Approach: Involves passing through skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, and arachnoid mater.
  • Paramedian or Lateral Approach: Similar to midline excluding supraspinous & interspinous ligaments.