Top Tweets for #spinalblock

12 months ago

🌟 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!"

McMaster Anesthesia @MacAnesthesia

over 2 years ago

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

MacAnesthesia's tweet photo. 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 https://t.co/f1bPFJ9bfJ

416

onthewards.org @onthewardsorg

over 5 years ago

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

MCPR @MCPRllc

almost 6 years ago

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

AMANDA EDS @EDSAmanda

over 6 years ago

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

louise grant @louisefgrant

over 6 years ago

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 💉

louisefgrant's tweet photo. 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 💉 https://t.co/K1bE6NtPXS

Chloe Jackson @ChloeZara11

about 7 years ago

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

Summer Stevens @SummerStevens3

over 10 years ago

Hubby is getting knee surgery. #spinalblock #GiveHimDrugs

___Grey__ @Dodgers_G

almost 11 years ago

Thank goodness for pain killers 🙌🏼😖 #backpain #oldpeopleproblems #spinalblock

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