Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast Episode 132: Key Words Part 3: Spinals and Etomidate
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Aug 5, 2019 Dr. Gillian Isaac, an anesthesiologist specialized in keyword reviews for the ABA basic exam, returns to discuss spinal anesthesia and etomidate. She breaks down the key elements, from patient characteristics to common misconceptions. The conversation dives into cardiovascular issues like hypotension during procedures and the importance of monitoring. Isaac also explores the pharmacological properties of etomidate, its stability, and the complications associated with both spinal anesthesia and the drug itself.
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Spinal Anatomy Approaches
- The paramedian spinal anesthesia approach skips the supraspinous and interspinous ligaments, unlike the midline approach.
- Correct needle path knowledge is crucial for spinal anesthesia questions on exams.
Predicting Spinal Block Height
- Predict spinal block height by considering anesthetic baricity and patient position.
- These two factors most strongly influence block spread and effectiveness.
Order of Spinal Blockade
- Sympathetic nerve block reaches higher levels than sensory or motor blocks in spinal anesthesia.
- The block sequence is sympathetic first, then sensory, and lastly motor.