Anesthesia Case Study

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REVIEW OF LITERATURE SPINAL ANAESTHESIA History Spinal anaesthesia, also referred to as SAB, intrathecal analgesia or central neuraxial blockade. Spinal anaesthesia is produced when a local anaesthetic agent is injected into the subarachnoid space and was the first major regional technique attempted. Spinal anaesthesia was initially produced inadvertently by J. Leonard Corning, a neurologist in New York in 1885. He accidentally pierced the duramater while experimenting with cocaine on spinal nerves of a dog. But spinal anesthesia could not become an acceptable means for use of cocaine until a safe predictable means for performing lumbar puncture was described.3 Quincke did this in 1891. In 1899, August Bier used Quincke`s technique to inject…show more content…
It is believed to result from leakage of CSF from a dural defect and decreased intracranial pressure. Loss of CSF at a rate faster than it can be produced causes traction on the structure supporting the brain, particularly the dura and tentorium. Increased traction on the blood vessels also likely contributes to the pain. Traction on cranial nerves occasionally cause diplopia (sixth nerve) and tinnitus. The incidence of PDPH is strongly related to needle size and type, and patient population. The larger the needle the greater incidence of PDPH. Cutting point needles are associated with higher incidence of PDPH compared to pencil point needle of the same gauge. A cutting needle introduced with bevel parallel to the longitudinal fibers of dura said to separate these fibers rather than transecting them, therefore reducing chances of…show more content…
He used a needle of which it is difficult to find a description, except that it was a sharp, bevelled, hollow needle. The needle used was described as a Quincke needle. Bier’s work caused a sensation in the medical world, with widespread acceptance of the technique for surgery, although Bier himself still had reservations. Over time, he developed his own needle. He felt that the use of introducers and dilators for the insertion of the finer needles previously used was cumbersome, and he designed a larger bore needle that needed no introducer. The Bier spinal needle was 15 G or 17 G, with a long, cutting bevel and a sharp

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