NURS 5450 Exam 1 - Basics Of Neuraxial Anesthesi:
Questions With Correct Solutions
Spinal and Epidural Anesthesia are collectively referred to as ______. Correct
Answer - central neuraxial block
Clinical uses for neuraxial anesthesia include: Correct Answer - • Can be
the sole surgical anesthetic (c section)
• Useful in conjunction with procedural sedation (hip fracture)
• Can be an adjunct to general anesthesia (combined technique)
• → an effective method in providing postoperative pain control
• Chronic pain management
How is spinal anesthesia accomplished? Correct Answer - By injecting
local anesthetic solution
into the CSF contained within the subarachnoid (intrathecal) space
________ is limited to the lumbar region below the spinal cord. Correct
Answer - Subarachnoid block (SAB)
The spinal cord ends at the level of vertebrae ________, while the subarachnoid
space —the compartment that contains cerebrospinal fluid— extends down to
the lower border of S2. Correct Answer - L1-L2
How is epidural anesthesia accomplished? Correct Answer - By injection of
local anesthetic solution into the space that lies within the vertebral canal but
outside or superficial to the dural sac
Where can epidural anesthesia be performed in the spinal column? Correct
Answer - Various Levels - (cervical, thoracic,
lumbar)
What is caudal anesthesia? Correct Answer - A special type of epidural
anesthesia
where local anesthesia is injected through the sacral hiatus into the epidural
space
, What are the benefits of a SAB? Correct Answer - Typically takes less time
to perform
- Causes less procedural discomfort
- Requires less anesthetic
- Produces a more intense block (motor and sensory)
- Easily confirmed with the appearance of
CSF
What are the benefits of an epidural anesthetic? Correct Answer - - Has a
decreased risk of postdural puncture headache (PDPH) - unless you nick the
arachnoid membrane - "wet tap"
- Lower incidence of systemic hypotension
- Has the ability to produce a segmental sensory block
- Greater control over the intensity of the sensory and motor block
- Provides a portal for subsequent local anesthetic and/or narcotic
administration
What are some pros of using neuraxial anesthesia? Correct Answer - • The
patient can remain completely awake for the operative procedure
• Skeletal muscle relaxation is profound with neuraxial blockade → no need
for neuromuscular blocking agents
What are some cons of using neuraxial anesthesia? Correct Answer - -
Patient anxiety (real and unfounded)
What is the primary concern with neuraxial anesthesia for procedures of the
upper abdomen? Correct Answer - Respiratory compromise - due to the
level needed for proper sensory block → combined anesthetic technique
What are the indications for neuraxial anesthesia? Correct Answer -
Surgical procedures of the:
• Lower abdominal area
• Perineum
• Lower extremities
What are the ABSOLUTE contraindications for neuraxial anesthesia?
Correct Answer - • Patient refusal
• Infection at the planned puncture site
• Coagulopathy
Questions With Correct Solutions
Spinal and Epidural Anesthesia are collectively referred to as ______. Correct
Answer - central neuraxial block
Clinical uses for neuraxial anesthesia include: Correct Answer - • Can be
the sole surgical anesthetic (c section)
• Useful in conjunction with procedural sedation (hip fracture)
• Can be an adjunct to general anesthesia (combined technique)
• → an effective method in providing postoperative pain control
• Chronic pain management
How is spinal anesthesia accomplished? Correct Answer - By injecting
local anesthetic solution
into the CSF contained within the subarachnoid (intrathecal) space
________ is limited to the lumbar region below the spinal cord. Correct
Answer - Subarachnoid block (SAB)
The spinal cord ends at the level of vertebrae ________, while the subarachnoid
space —the compartment that contains cerebrospinal fluid— extends down to
the lower border of S2. Correct Answer - L1-L2
How is epidural anesthesia accomplished? Correct Answer - By injection of
local anesthetic solution into the space that lies within the vertebral canal but
outside or superficial to the dural sac
Where can epidural anesthesia be performed in the spinal column? Correct
Answer - Various Levels - (cervical, thoracic,
lumbar)
What is caudal anesthesia? Correct Answer - A special type of epidural
anesthesia
where local anesthesia is injected through the sacral hiatus into the epidural
space
, What are the benefits of a SAB? Correct Answer - Typically takes less time
to perform
- Causes less procedural discomfort
- Requires less anesthetic
- Produces a more intense block (motor and sensory)
- Easily confirmed with the appearance of
CSF
What are the benefits of an epidural anesthetic? Correct Answer - - Has a
decreased risk of postdural puncture headache (PDPH) - unless you nick the
arachnoid membrane - "wet tap"
- Lower incidence of systemic hypotension
- Has the ability to produce a segmental sensory block
- Greater control over the intensity of the sensory and motor block
- Provides a portal for subsequent local anesthetic and/or narcotic
administration
What are some pros of using neuraxial anesthesia? Correct Answer - • The
patient can remain completely awake for the operative procedure
• Skeletal muscle relaxation is profound with neuraxial blockade → no need
for neuromuscular blocking agents
What are some cons of using neuraxial anesthesia? Correct Answer - -
Patient anxiety (real and unfounded)
What is the primary concern with neuraxial anesthesia for procedures of the
upper abdomen? Correct Answer - Respiratory compromise - due to the
level needed for proper sensory block → combined anesthetic technique
What are the indications for neuraxial anesthesia? Correct Answer -
Surgical procedures of the:
• Lower abdominal area
• Perineum
• Lower extremities
What are the ABSOLUTE contraindications for neuraxial anesthesia?
Correct Answer - • Patient refusal
• Infection at the planned puncture site
• Coagulopathy
