BIMS 201 Lecture Notes - Lecture 13: Sinus Bradycardia, Local Anesthetic, Epidural Administration
7 Jan 2018
School
Department
Course
Professor
Document Summary
Complications of local anaesthetics: local systemic toxicity: due to accidental intravascular injection of la drugs or excessive dose. Sudden alteration of mental status, severe agitation, loss of consciousness ,with or without tonic-clonic convulsions. Cardiovascular collapse: sinus bradycardia, conduction blocks,asystole, and ventricular tachyarrhymias. For seizures consider thiopentone small doses iv. Careful, repeated aspiration using fractionated injections: others complications: Vaso-vagal attack- in anxiety. causes pallor, bradycardia, syncope, hypotension. Nerve injury, neuritis needle injury, chemical, bacterial contamination, injection of incorrect solution: equipment problems: Preoperative assessment, preoperative preparation, fasting guidelines, monitoring and postoperative care are same as for general anaesthesia. Absolute contra-indications: coagulopathy, anticoagulant treatmemt, patient refusal, uncooperative patient, la drug allergy, infection at site of injection, other contraindications depending upon the type of local anaesthetic techniques considered. Intermittent boluses: repeated injections or via indwelling catheters. The spinal cord terminates at approximately l1 in adults & l3 in infants. The line joining the iliac crest (cid:894)intercristine ot tuffier"s line(cid:895) is approximately at the l4 level.
