Before surgery, appropriate testing must be undertaken.

When spinal is used as the sole means of anaesthesia for a procedure, thorough testing is vital.

Question: Take a moment to consider: what is the precise purpose of testing a spinal?

Click here for the answer.

Before surgery, appropriate testing must be undertaken.

When spinal is used as the sole means of anaesthesia for a procedure, thorough testing is vital.

Question: Take a moment to consider: what is the precise purpose of testing a spinal?

Answer:

The test applied at the time of testing needs to be predictive of comfort for the duration of the proposed surgery, not just to test that the block is working at that time. It is important to appreciate this.

Most commonly, testing the upper level blocked to cold is used, e.g. ethyl chloride spray.

For simple surgery to the perineum, e.g. haemorrhoidectomy or circumcision, a block of the sacral sensory nerve roots is sufficient.

For surgery of the leg, e.g. primary hip or knee replacement, a block to T10 is sufficient for surgery of typical duration.

For caesarean section, a much higher block is used; a block to the fifth thoracic dermatome (T5) is recommended and there are suggestions that lack of light touch sensation may be a better predictor of pain-free surgery than lack of cold sensation.