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This category contains 4 posts

Beachchair and Blood Pressure

It is now more than 5 years since the Anesthesia Patient Safety Foundation highlighted the risk of central nervous system injury following anesthesia for shoulder surgery (SS) in the Beachchair position (BCP) (click here). Although we can never be certain, it appears likely that such injuries – principally devastating stroke, results from hypoperfusion and watershed ischaemia. … Continue reading

Ultrasound for Neuraxial Anaesthesia

Most of the time that we palpate the spine (70%) we are incorrect at assessing the level of the spine that we are palpating blindly. In the future ultrasound guidance will be standard of care for spinal anesthesia, according to Jose Carvlho, from Toronto at the Western Anaesthesia Symposium. Does the line drawn across the … Continue reading

Vasopressors for Hypotension During Cesarean Delivery Under Spinal Anesthesia

Anesth Analg. 2012 Feb;114(2):377-90 Vasopressor use during neuraxial anaesthesia/analgesia is more prevalent today than ever before. It is my impression that phenylephrine has emerged as the defacto pressor of choice over the past decade.  However, in 2001 95% of consultant anaesthetists used ephedrine exclusively (Burns Anaesthesia 2001). What has changed over that decade? A series … Continue reading

Local Anaesthesia Toxicity (tutorial)

Patrick Neligan, Consultant in Anaesthesia & Intensive Care, Galway University Hospitals (c) Clinical Scenario A 37 year old female undergoes bilateral mammoplasty. The procedure is performed under general anaesthesia. Prior to incision the wound was infiltrated with 20ml of 1% lignocaine, on each side. Intraoperatively the patient’s temperature was 37.5 degrees celcius, heart rate was 100 … Continue reading