Top Tweets for #AnaesthesiaTips

2 months ago

🎯 𝐍𝐄𝐔𝐑𝐀𝐗𝐈𝐀𝐋 𝐍𝐀𝐕𝐈𝐆𝐀𝐓𝐈𝐎𝐍: 𝐏𝐫𝐚𝐜𝐭𝐢𝐜𝐚𝐥 𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞-𝐒𝐩𝐞𝐜𝐢𝐟𝐢𝐜 𝐓𝐫𝐢𝐜𝐤𝐬 🎯 #RegionalAnesthesia #NeuraxialAnaesthesia #AnaesthesiaTips #MyRATips #TipOfTheDay 𝐓𝐢𝐩 𝐨𝐟 𝐭𝐡𝐞 𝐃𝐚𝐲: 🧭 𝐒𝐂𝐎𝐏𝐄 𝐎𝐅 𝐓𝐇𝐈𝐒 𝐆𝐔𝐈𝐃𝐄 🔹 These points apply to conventional lumbar neuraxial techniques. 🔹 Thoracic spinal anesthesia is an entirely different concept & should not be interpreted using the same rules. 🔹 Always individualize according to patient profile, surgical duration, anticoagulation status, hemodynamics, & institutional protocols. 🎯 𝐂𝐎𝐑𝐄 𝐑𝐔𝐋𝐄 🔹 Keep the puncture level safely lumbar: usually L3–L4 or L4–L5. 🔹 For ankle/foot surgery, L4–L5 is often ideal. 🔹 The surgery decides the target sensory level, not the puncture site. 🔹 Use ultrasound marking in obese, elderly, scoliosis, or difficult-spine patients. 🦴 𝐏𝐑𝐎𝐂𝐄𝐃𝐔𝐑𝐄-𝐖𝐈𝐒𝐄 𝐏𝐋𝐀𝐍𝐍𝐈𝐍𝐆 🔹 Acetabulum/pelvis: aim for T6–T8; CSEA is useful for long, painful, or unpredictable-duration surgery. 🔹 Hip surgery: aim for T8–T10; balance reliable anesthesia with hemodynamic safety, especially in elderly fracture patients. 🔹 Knee/TKA: aim for T10–T12; remember tourniquet pain may need better coverage than incision pain alone. 🔹 Ankle/foot: aim for T12–L1; avoid unnecessarily high spinal spread. 🔹 Lower abdominal wall: aim for T6–T8; lumbar spinal/CSEA may be suitable. 🔹 Upper abdominal wall: prefer thoracic epidural or GA + thoracic epidural; lumbar spinal alone is usually not ideal. 💉 𝐂𝐒𝐄𝐀 𝐓𝐎𝐏𝐔𝐏 𝐋𝐎𝐆𝐈𝐂 🔹 If a full-dose spinal is given, AVOID routine early epidural top-up. 🔹 FIRST EPIDURAL TOP-UP is usually around 90–120 minutes or when regression, pain, or surgical extension appears. 🔹 If a low-dose spinal is used, assess block height at 10–15 minutes. 🔹 If the level is inadequate, consider epidural top-up at 15–20 minutes. 🔹 Use small fractionated epidural aliquots, commonly 3–5 mL, with reassessment after each bolus. ⚠️ 𝐖𝐇𝐘 𝐅𝐑𝐀𝐂𝐓𝐈𝐎𝐍𝐀𝐓𝐈𝐎𝐍 𝐌𝐀𝐓𝐓𝐄𝐑𝐒 🔹 Large early epidural boluses after spinal may push intrathecal drug cephalad & increase the risk of unexpectedly high block. 🔹 Avoid sudden large-volume epidural supplementation soon after spinal. 🔹 Fractionate. Titrate. Reassess. 🌡️ 𝐏𝐎𝐒𝐓𝐎𝐏𝐄𝐑𝐀𝐓𝐈𝐕𝐄 𝐄𝐏𝐈𝐃𝐔𝐑𝐀𝐋 𝐂𝐎𝐍𝐂𝐄𝐏𝐓 🔹 Use dilute LA solutions & titrate according to pain, sensory coverage, motor power, & blood pressure. 🔹 Acetabulum/pelvis: usually needs stronger & longer coverage. 🔹 Hip: maintain analgesia without delaying mobilization. 🔹 Knee / TKA: preserve quadriceps power; avoid dense motor block. 🔹 Ankle/foot: usually avoid epidural; prefer PNBs/catheter if prolonged analgesia is needed. 🔹 Abdominal wall: match epidural level & infusion to incision height. 🛠️ 𝐓𝐄𝐂𝐇𝐍𝐈𝐂𝐀𝐋 𝐏𝐄𝐀𝐑𝐋𝐒 🔹 𝐀𝐜𝐞𝐭𝐚𝐛𝐮𝐥𝐮𝐦: plan for long duration, traction, deep bony pain, & postop analgesia. 🔹 𝐇𝐢𝐩 𝐟𝐫𝐚𝐜𝐭𝐮𝐫𝐞: provide analgesia before positioning; paramedian approach often helps. 🔹 𝐊𝐧𝐞𝐞:cover tourniquet pain, not just incision pain. 🔹 𝐀𝐧𝐤𝐥𝐞: do not over-spinalize. 🔹 𝐃𝐢𝐟𝐟𝐢𝐜𝐮𝐥𝐭 𝐬𝐩𝐢𝐧𝐞: use preprocedural ultrasound to mark midline, interspace, depth, and angle. 🔹 𝐄𝐚𝐫𝐥𝐲 𝐦𝐨𝐛𝐢𝐥𝐢𝐳𝐚𝐭𝐢𝐨𝐧: use low-concentration epidural solutions & MMA. ✅ 𝐓𝐀𝐊𝐄-𝐇𝐎𝐌𝐄 🔹 𝐀𝐧𝐤𝐥𝐞: keep it low. 🔹 𝐊𝐧𝐞𝐞: cover tourniquet, preserve quadriceps. 🔹 𝐇𝐢𝐩: reliable spinal with hemodynamic safety. 🔹 𝐀𝐜𝐞𝐭𝐚𝐛𝐮𝐥𝐮𝐦: plan for duration & postoperative pain. 🔹 𝐋𝐨𝐰𝐞𝐫 𝐚𝐛𝐝𝐨𝐦𝐢𝐧𝐚𝐥 𝐰𝐚𝐥𝐥: match block height to incision level. 🔹 𝐔𝐩𝐩𝐞𝐫 𝐚𝐛𝐝𝐨𝐦𝐢𝐧𝐚𝐥 𝐰𝐚𝐥𝐥: think thoracic epidural, not lumbar spinal alone. 🔹 𝐂𝐒𝐄𝐀: full-dose spinal means delayed top-up; low-dose spinal means planned early titration. 🔹 𝐆𝐨𝐥𝐝𝐞𝐧 𝐫𝐮𝐥𝐞: safe lumbar entry, correct sensory target, cautious epidural supplementation. ⚕️ PATIENT first. PLAN smart. STAY ahead.⚕️

$KartikBSonawane's tweet photo. 🎯 𝐍𝐄𝐔𝐑𝐀𝐗𝐈𝐀𝐋 𝐍𝐀𝐕𝐈𝐆𝐀𝐓𝐈𝐎𝐍: 𝐏𝐫𝐚𝐜𝐭𝐢𝐜𝐚𝐥 𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞-𝐒𝐩𝐞𝐜𝐢𝐟𝐢𝐜 𝐓𝐫𝐢𝐜𝐤𝐬 🎯 #RegionalAnesthesia #NeuraxialAnaesthesia #AnaesthesiaTips #MyRATips #TipOfTheDay 𝐓𝐢𝐩 𝐨𝐟 𝐭𝐡𝐞 𝐃𝐚𝐲: 🧭 𝐒𝐂𝐎𝐏𝐄 𝐎𝐅 𝐓𝐇𝐈𝐒 𝐆𝐔𝐈𝐃𝐄 🔹 These points apply to conventional lumbar neuraxial techniques. 🔹 Thoracic spinal anesthesia is an entirely different concept & should not be interpreted using the same rules. 🔹 Always individualize according to patient profile, surgical duration, anticoagulation status, hemodynamics, & institutional protocols. 🎯 𝐂𝐎𝐑𝐄 𝐑𝐔𝐋𝐄 🔹 Keep the puncture level safely lumbar: usually L3–L4 or L4–L5. 🔹 For ankle/foot surgery, L4–L5 is often ideal. 🔹 The surgery decides the target sensory level, not the puncture site. 🔹 Use ultrasound marking in obese, elderly, scoliosis, or difficult-spine patients. 🦴 𝐏𝐑𝐎𝐂𝐄𝐃𝐔𝐑𝐄-𝐖𝐈𝐒𝐄 𝐏𝐋𝐀𝐍𝐍𝐈𝐍𝐆 🔹 Acetabulum/pelvis: aim for T6–T8; CSEA is useful for long, painful, or unpredictable-duration surgery. 🔹 Hip surgery: aim for T8–T10; balance reliable anesthesia with hemodynamic safety, especially in elderly fracture patients. 🔹 Knee/TKA: aim for T10–T12; remember tourniquet pain may need better coverage than incision pain alone. 🔹 Ankle/foot: aim for T12–L1; avoid unnecessarily high spinal spread. 🔹 Lower abdominal wall: aim for T6–T8; lumbar spinal/CSEA may be suitable. 🔹 Upper abdominal wall: prefer thoracic epidural or GA + thoracic epidural; lumbar spinal alone is usually not ideal. 💉 𝐂𝐒𝐄𝐀 𝐓𝐎𝐏𝐔𝐏 𝐋𝐎𝐆𝐈𝐂 🔹 If a full-dose spinal is given, AVOID routine early epidural top-up. 🔹 FIRST EPIDURAL TOP-UP is usually around 90–120 minutes or when regression, pain, or surgical extension appears. 🔹 If a low-dose spinal is used, assess block height at 10–15 minutes. 🔹 If the level is inadequate, consider epidural top-up at 15–20 minutes. 🔹 Use small fractionated epidural aliquots, commonly 3–5 mL, with reassessment after each bolus. ⚠️ 𝐖𝐇𝐘 𝐅𝐑𝐀𝐂𝐓𝐈𝐎𝐍𝐀𝐓𝐈𝐎𝐍 𝐌𝐀𝐓𝐓𝐄𝐑𝐒 🔹 Large early epidural boluses after spinal may push intrathecal drug cephalad & increase the risk of unexpectedly high block. 🔹 Avoid sudden large-volume epidural supplementation soon after spinal. 🔹 Fractionate. Titrate. Reassess. 🌡️ 𝐏𝐎𝐒𝐓𝐎𝐏𝐄𝐑𝐀𝐓𝐈𝐕𝐄 𝐄𝐏𝐈𝐃𝐔𝐑𝐀𝐋 𝐂𝐎𝐍𝐂𝐄𝐏𝐓 🔹 Use dilute LA solutions & titrate according to pain, sensory coverage, motor power, & blood pressure. 🔹 Acetabulum/pelvis: usually needs stronger & longer coverage. 🔹 Hip: maintain analgesia without delaying mobilization. 🔹 Knee / TKA: preserve quadriceps power; avoid dense motor block. 🔹 Ankle/foot: usually avoid epidural; prefer PNBs/catheter if prolonged analgesia is needed. 🔹 Abdominal wall: match epidural level & infusion to incision height. 🛠️ 𝐓𝐄𝐂𝐇𝐍𝐈𝐂𝐀𝐋 𝐏𝐄𝐀𝐑𝐋𝐒 🔹 𝐀𝐜𝐞𝐭𝐚𝐛𝐮𝐥𝐮𝐦: plan for long duration, traction, deep bony pain, & postop analgesia. 🔹 𝐇𝐢𝐩 𝐟𝐫𝐚𝐜𝐭𝐮𝐫𝐞: provide analgesia before positioning; paramedian approach often helps. 🔹 𝐊𝐧𝐞𝐞:cover tourniquet pain, not just incision pain. 🔹 𝐀𝐧𝐤𝐥𝐞: do not over-spinalize. 🔹 𝐃𝐢𝐟𝐟𝐢𝐜𝐮𝐥𝐭 𝐬𝐩𝐢𝐧𝐞: use preprocedural ultrasound to mark midline, interspace, depth, and angle. 🔹 𝐄𝐚𝐫𝐥𝐲 𝐦𝐨𝐛𝐢𝐥𝐢𝐳𝐚𝐭𝐢𝐨𝐧: use low-concentration epidural solutions & MMA. ✅ 𝐓𝐀𝐊𝐄-𝐇𝐎𝐌𝐄 🔹 𝐀𝐧𝐤𝐥𝐞: keep it low. 🔹 𝐊𝐧𝐞𝐞: cover tourniquet, preserve quadriceps. 🔹 𝐇𝐢𝐩: reliable spinal with hemodynamic safety. 🔹 𝐀𝐜𝐞𝐭𝐚𝐛𝐮𝐥𝐮𝐦: plan for duration & postoperative pain. 🔹 𝐋𝐨𝐰𝐞𝐫 𝐚𝐛𝐝𝐨𝐦𝐢𝐧𝐚𝐥 𝐰𝐚𝐥𝐥: match block height to incision level. 🔹 𝐔𝐩𝐩𝐞𝐫 𝐚𝐛𝐝𝐨𝐦𝐢𝐧𝐚𝐥 𝐰𝐚𝐥𝐥: think thoracic epidural, not lumbar spinal alone. 🔹 𝐂𝐒𝐄𝐀: full-dose spinal means delayed top-up; low-dose spinal means planned early titration. 🔹 𝐆𝐨𝐥𝐝𝐞𝐧 𝐫𝐮𝐥𝐞: safe lumbar entry, correct sensory target, cautious epidural supplementation. ⚕️ PATIENT first. PLAN smart. STAY ahead.⚕️$

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British Journal of Anaesthesia @BJAJournals

about 1 year ago

🧠 Cognitive Load in Emergencies Hyperangulated videolaryngoscopy can reduce cognitive load during airway emergencies by providing better visualisation. But preparation is key. 📖 Understand the dynamics: https://t.co/HcWVRch23v #CriticalCare #AnaesthesiaTips #PatientSafety

BJAJournals's tweet photo. 🧠 Cognitive Load in Emergencies
Hyperangulated videolaryngoscopy can reduce cognitive load during airway emergencies by providing better visualisation. But preparation is key.
📖 Understand the dynamics: https://t.co/HcWVRch23v
#CriticalCare #AnaesthesiaTips #PatientSafety https://t.co/s1xRX8wUJf

British Journal of Anaesthesia @BJAJournals

about 1 year ago

When PONV Hits — Treat Promptly! 🚨Rescue therapy should be from a different drug class than the original prophylactic. 🚫Avoid repeating the same ineffective agent. 🕒The sooner, the better. #AnaesthesiaTips #PONVRescue #ChildHealth #BJAEducation https://t.co/QmTGjGjHbK

BJAJournals's tweet photo. When PONV Hits — Treat Promptly!
🚨Rescue therapy should be from a different drug class than the original prophylactic.
🚫Avoid repeating the same ineffective agent.
🕒The sooner, the better.
#AnaesthesiaTips #PONVRescue #ChildHealth #BJAEducation
https://t.co/QmTGjGjHbK https://t.co/WFU97rwqnE

British Journal of Anaesthesia @BJAJournals

about 1 year ago

Spot the High-Risk Child 🔍 Risk factors for PONV include: 🧒 Age >3 🚺 Female sex 🧬 Family history 🌡️ Volatile anaesthetics & opioids Assess and plan — not all kids are the same. #AnaesthesiaTips #PONVRisk #BJAEducation #PatientSafety Read more: https://t.co/QmTGjGjHbK

British Journal of Anaesthesia @BJAJournals

about 1 year ago

🧰 Stylets & Bougies: The Unsung Heroes When using hyperangulated blades, the right adjuncts make all the difference. Understand when and how to use stylets and bougies effectively in this month's #BJAEducation article: 📚 https://t.co/WLmxLka8a5 #AirwayTools #AnaesthesiaTips

BJAJournals's tweet photo. 🧰 Stylets & Bougies: The Unsung Heroes
When using hyperangulated blades, the right adjuncts make all the difference. Understand when and how to use stylets and bougies effectively in this month's #BJAEducation article:
📚 https://t.co/WLmxLka8a5
#AirwayTools #AnaesthesiaTips https://t.co/Com9qfh0hG

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