Top Tweets for #SpinalBlock
🌟 Mastering Spinal Dosing: From Babies to the Elderly! 🌟
#SpinalAnesthesia #SafeSpinals
#RegionalAnesthesia #SpinalBlock
#NeuraxialAnesthesia #AnesthesiaMatters #PediatricAnesthesia #GeriatricAnesthesia #AnesthesiaTips #FellowshipLearning #TipOfTheDay #MyRATips
Tip of the Day:
A simple guide to make spinal anesthesia less confusing and more confident!
A. 🧠 How Do We Decide the Spinal Dose?
🔹The dose of spinal anesthetic isn’t “one-size-fits-all.”
🔹Customize it based on the patient’s profile, surgery site, and local anesthetic characteristics.
B.📌 Tips for Beginners
✅ Ask 2 things:
💡“What level of block do I need?”
💡“Can this patient tolerate high spinal spread?”
✅Start with the standard dose:
💡Adjust up or down based on: Height, Age, Comorbidities (like kyphosis, obesity, severe AS, scoliosis)
✅ When unsure – Use spinal opioid adjuvants to reduce LA dose but maintain analgesia.
✅ Keep a quick "SPINAL DOSING QUICK REFERENCE CARD " in your pocket.
✅ When in doubt - start conservatively, observe, and document spread.
C. 🔑 Key Factors That Influence Spinal Dose
1. 🧍♂️ Height
🔸Short (<150 cm): Slightly lower dose
🔸Tall (>180 cm): May need full dose
🔸Rationale: Taller people have a longer spinal column, so drug may spread less unless compensated.
2. ⚖️ Weight & BMI
👉Obese patients have reduced CSF volume → increased spread → use less
👉Very thin: May also need lower dose
3. 🎂 Age
🧩Elderly have less CSF + increased nerve sensitivity → use 10–20% less
🧩Young adults: standard dose
🧩Infants/children: strictly weight-based
4. 🩺 Surgery Site
📌Perineal: S2–S4 → ~1.2–1.5 mL
📌Lower limb ortho: T10–T12 → ~2.0–2.5 mL
📌LSCS/Gyn: T6–T8 → ~1.6–2.0 mL
📌Lower abdominal: T4–T6 → ~2.5–3.0 mL
5.🤰 Pregnancy
💡Less CSF, increased vascularity → reduce dose
6.📏 Baricity & Position
📍Hyperbaric: spreads with gravity (adjust table tilt)
📍Hypobaric/Isobaric: less predictable; position critical
D.👶 Pediatric (esp. <8 years):
☑️CSF volume is higher per kg than adults → requires more mL/segment
☑️General rule: 0.05–0.07 mL/kg/spinal segment (for hyperbaric bupivacaine) Or overall dose: 0.4–0.5 mg/kg
☑️Example, a 10-kg child needing T10 block (around 6–8 segments): ~0.7 mL total of 0.5% bupivacaine.
E. 👨⚕️ Adults:
➡️Not commonly taught as mL/segment because dosing is not linear.
➡️ 0.1–0.15 mL/segment can give some approximation, only in average-sized adults
➡️Example, for a T4 level (approx. 14 segments from S5): 2.0–2.5 mL of 0.5% hyperbaric bupivacaine.
➡️Remember LA spread is governed by gravity, baricity, CSF volume, and patient factors, not just volume.
F. 👵 Elderly:
👉Decreased CSF volume, increased sensitivity to LA, less compliance.
👉Need less volume/segment → 0.08–0.1 mL/segment
👉Example, in an 80-year-old, 1.2–1.4 mL may be enough for a T8 level
G.✅ Safe Geriatric Dosing (Bupivacaine 0.5% Heavy)
🦴 Hip Surgery (T10–T12 level)
🔸Dose: 1.2–1.5 mL
🔸Use adjuvants (e.g., fentanyl 15–20 mcg) to enhance effect with reduced LA volume.
🦵 Knee/Lower Limb Ortho (T10–T12 level)
🔹Dose: 1.0–1.4 mL
🔹Reduce to as low as 0.8–1.0 mL if frail or kyphotic.
📌 Tips for Geriatric Safety:
🎯Use smaller gauge needle (25G/27G pencil-point)
🎯Keep head slightly elevated to avoid high spinal
🎯Monitor for bradycardia, hypotension more closely
🎯Consider preloading + gentle vasopressor titration
🎯Maintain MAP = Age of the Patient
H.🚀🏠Take-Home Messages🎯
💉 Spinal dose is never fixed — always tailor to the patient.
👶 Pediatrics: Use 0.08–0.1 mL/kg of 0.5% bupivacaine.
🧍 Adults need 1.5–3.0 mL based on surgery level.
🧓 Elderly? Go low — 1.0 to 1.4 mL is often enough.
👩🦰 Pregnant or obese? Reduce dose by 10–20%.
🛌 Baricity and position guide your block spread.
💊 Opioid adjuvants = lower LA, longer relief.
📏 No fixed mL/segment - think clinically, not mathematically.
🧠 Ask: What level do I need? Can the patient tolerate it?
🚨 Watch for high spinal signs - and act fast.
"When it comes to spinal dosing — think smart, dose small, and aim precise!"
Check out this week's Research Spotlight 🔦 about a recent case study article from Dr. James Paul!
Tap the images to see a brief overview of the article, or read the full review at https://t.co/HEG2tIUO6D
#macanesthesia #anesthesia #csection
#casestudy #spinalblock #research
What I wish I knew about spinals and epidurals as an O&G Resident https://t.co/H5ZfAyZWE2 #obstetrics #gynaecology #anaesthetics #epidural #spinalblock #Caesarean #womenshealth #tipsofnewdocs #juniordocs #medicalstudents #painmanagement
Learn from @romper about getting a spinal block during a c-section with comments from OBGYN @keciagaithermd. Thanks @CatTBowen #spinalblock #pregnancy #csection #pregnant https://t.co/D2wVChe6k2
Are you having #SpinalBlock #spinalanaesthesia for your #THR? Watch @louisegranthip from @Physiocure1 demonstrate exercises to do whilst you're awaiting that needle. Help mobilise the spine whilst you wait.Might help to distract you from being nervous too https://t.co/6sY4zgTz5N
Having spinal block for surgery? Why not spend time waiting mobilising the spine so you can get in position more easily for the big needle bit 💉
Today’s the day... 6.50am and I’m at the Hospital, I’m absolutely terrified but I’m ready for surgery! 🏥👩🏼⚕️💉 #hospital #surgery #operation #tuesday #morning #spinalblock #illness #letsdothis https://t.co/nmuqkynnD7
Last Seen Hashtags on Sotwe
Most Popular Users
Elon Musk 
@elonmusk
240.7M followers
Barack Obama
@barackobama
119.2M followers
Donald J. Trump
@realdonaldtrump
111.7M followers
Cristiano Ronaldo
@cristiano
110.8M followers
Narendra Modi
@narendramodi
107M followers
Rihanna
@rihanna
97.7M followers
NASA
@nasa
92.2M followers
Justin Bieber
@justinbieber
90.9M followers
KATY PERRY
@katyperry
87.8M followers
Taylor Swift
@taylorswift13
81.6M followers
Lady Gaga
@ladygaga
73.1M followers
Virat Kohli
@imvkohli
70M followers
Kim Kardashian
@kimkardashian
69.8M followers
YouTube
@youtube
68.7M followers
Bill Gates
@billgates
63.9M followers
Neymar Jr
@neymarjr
62.8M followers
The Ellen Show
@theellenshow
62.4M followers
CNN
@cnn
61.9M followers
Selena Gomez
@selenagomez
60.9M followers
X
@x
60.8M followers