Published On Apr 18, 2024
At NYSORA, Spinal anesthesia is our first choice for nearly all ASA II- and ASA IV patients who do not have contraindications for spinal. While general anesthesia can always be used, the intraoperative course is much more stable and requires less invasive monitoring with low doses, particularly isobaric spinal anesthesia. In this video, I will take you through the anesthesia management of a septic patient with an infected knee prosthesis who is scheduled for removal of the prosthesis. As you will see in the video, these patients are often very ill, have fever and difficulty breathing. In the video we will take you through the performance of a femoral nerve block for patient positioning and postoperative analgesia, and spinal anesthesia in the lateral position, using a paramedial approach and 10 mg of isobaric bupivacaine 0.5% which results in over 3 hours of anesthesia. The use of both spinal anesthesia and a femoral nerve block helps manage perioperative stability and pain, which is crucial in such critically ill patients. However, the key to the success here is the technical ability to perform spinal anesthesia properly, which does require adequate training and adherence to practice standards with regard to the choice and dose of the local anesthetic. Let's watch the video.
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