rapid sequence spinal anesthesia for beginners

rapid sequence spinal anesthesia

1. RAPID SEQUENCE SPINAL for category-1 caesarean section

2. contents What is Rapid Sequence Spinal Anaesthesia (RSS)? How is RSS performs? Why is RSS? Not Rapid Sequence General Anaesthesia (RSGA)? Evidence-based? Area of Controversy..

3. Category of urgency of cs

4. What is RSS? First described by Kinsella in 2003 Developed as technique for the most urgent Category 1 caesarian section in the NICE guidelines This technique simplifies the process of spinal anaesthesia aiming to shorten time to administration & to avoid the potential risks of GA Steps that are not indispensable for spinal anaesthesia placement are omitted

5. What is RSS? Comparing spinal anaesthesia for elective caesarian section, RSS is characterized by difference in: Methods of sterilization Dose of anaesthetics Required level of anaesthesia before starting surgery

6. Components of rapid sequence spinal 1.No touch spinal technique 2.Consideration to omit spinal opioid 3.Limiting spinal attempts 4.Allowing surgery to start before establishment of spinal block 5.Prepared for conversion to GA if there are delays or problems For safe and timely RSSA, cooperative work is mandatory with good team relation for simultaneous and necessary tasks

7. How is rss perform?

8. Or skin prepared with single wipe of 0.5% chlorhexidine solution

9. Why is rapid sequence spinal? Not rsga?

10. Evidence-based

11. Area of Controversy.. Risk of infection compared between normal spinal anesthetic technique with standard antiseptic technique and RSS with single antiseptic application 3690 patients were received rapid sequence spinal anesthesia with single chlorhexidine in alcohol application with time period between 1991 and 1999 showed no infection so it is safe to practice for those conditions alcoholic providone iodine has comparable efficacy with chlorhexidine 0.5% in alcohol if used as antiseptic solution for neuraxial blockade and surgical site skin preparation

12. Area of Controversy.. Timing to attain rapid sequence spinal anesthesia when compared with rapid sequence general anesthesia in case of difficulty Need to consider about risks of unanticipated difficult airway, high risk of aspiration and pulmonary damage, delayed awakening, multidrug exposure of the fetus and other potential morbidities during general anesthesia

13. In conclusion.. It is important to note that successful RSS requires effective deployment of medical staffs and teamwork. Obstetrician Paediatrician Nurses in the operating room, obstetric suite and Neonatal Intensive Care Unit Repeated discussions to clarify the role of each staff to create a local protocol for RSS RSS may be equivalent to RSGA in Category 1 Caesarian section, however, RSGA may still have role in certain scenario Understanding the clinical scenario resulting in a caesarian section is fundamental

14. References Rapid sequence spinal anaesthesia Vs. General Anaesthesia for Category-1 Caesarian Section – Dr. Ravi Gurvani, Dr. Dharam Veer, International Journal of Innovative Research in Medical Science (IJIRMS) Volume 03 Issue 01 January 2018, ISSN No. - 2455-8737 Kinsella SM, Girgirah K, Scrutton MJ. Rapid sequence spinal for category 1 urgency caesarean section: A case series. Anaesthesia 2010 Jigajinni SV, Rajala B, El Sharawi N. The rapid sequence spinal for category 1 caesarean section: anaesthetic trainee knowledge and practice. J Perioper Pract. 2015 National Institute of Health and Clinical Excellence. Caesarean section: Clinical Guideline, CG13: Caesarean section; 2004 Scrutton  M, Kinsella  SM. The immediate caesarean section: Rapid‑sequence spinal and risk of infection. Int J Obstet Anesth 2003 Abatneh Feleke Agegnehu* , Amare Hailekiros Gebregzi, Nigussie Simeneh Endalew. Review of evidences for management of rapid sequence spinal anesthesia for category one cesarean section, in resource limiting setting. International Journal of Surgery Open, volume 26, 2020 Dr Gita Nath, Dr Muhammad Waseem Athar. Anaesthesia for Caesarian Delivery – Best Practices. ATOTW, September 2021

15. Thank you.. Questions?