BIMS 201 Lecture Notes - Lecture 15: Aortic Stenosis, Bleeding Diathesis, Anal Fissure

• School: Texas A&M University
• Department: Biomedical Science
• Course: BIMS 201
• Professor: Elizabeth A.Crouch

Document Summary

Paradoxical bezold-jarisch reflex: decresed venous return and increased sympathetic tone causes forceful contraction of near empty left ventricle with consequent parasympathetically mediated arterial vasodilation and bradycardia, block of cardiac sympathetic fibers. (t1-t4) Careful positioning, preloading with iv fluids, maintaining normal circulating volume and use of vasopressors -ephedrine should counter these effects. In general lower abdominal, pelvic and lower limb surgeries. Obstertics: lscs,manual removal of placenta, cervical tear repair. Gynaecology hysterctomy, fallopian tube ligation, cervical polypectomy, pelvic floor strengthening etc. Total hip & knee replacent, knee arthroscopy & ligament repair etc. Absolute: bleeding diathesis, patient refusal, uncooperative patient, hypovolaemia, sepsis- local & systemic, severe stenotic valvular diseases aortic stenosis, acute neurological diseases and increased intra-cranial pressure, anti-coagulants treatment, severe spinal deformity, la drugs allergy. Introduction of local anaesthetic drugs into subarchnoid space incsf. Spinal needle shoul be introduced only after ending of spinal cord. Adults l3 l4, l4 l5, l5- l1 to avoid needle injury to spinal cord.