Neuraxial blocks as a primary anesthetic technique can be used for following surgeries except:
Correct Answer: Upper abdominal surgery
Description: Upper abdominal surgery, it is difficult to safely achieve a sensory level adequate for patient comfo with neuraxial anaesthesia. Thus for upper abdominal surgery epidural is used as an adjunct technique with general anaesthesia. Indications Indications for epidural nerve block can be divided into the following categories: Sole epidural anesthetic Epidural anesthetic in combination with spinal anesthetic This combination is referred to as combined spinal epidural (CSE). All of the indications noted above for sole epidural anesthetic may also be performed with CSE. Epidural anesthetic in combination with general anesthetic All of the indications noted above for sole epidural anesthetic may also be performed with CSE. Epidural analgesia combined with general anesthesia reduces the incidence of postoperative pneumonia in patients with chronic obstructive pulmonary disease who are undergoing major abdominal surgery. Epidural analgesia Prolonged postoperative analgesia obtained by continuous or patient-controlled infusions of local anesthetics, opioids, adjuvants, or a combination thereof Labor epidural analgesia Single-shot epidural injection of depot form of morphine (Duramorph) can provide 6-24 hours of analgesia. Epidural for chronic pain management Disk herniation, degeneration, and spondylosis Radiculopathy - Spinal stenosis and facet ahropathy Sympathetic mediated/maintained pain of upper or lower extremities
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Anaesthesia
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