Difficult spinal, needle as the examining tool - Regional anesthesia Crash course with Dr. Hadzic

Difficult spinal anesthesia, needle as the examining tool explained

Spinal anesthesia is an essential procedure skill for a practicing anesthesiologist. The technique is featured in every anesthesia textbook. It is sufficiently simple and straightforward so that most practitioners and “occasional regionalists” can use it in daily practice with adequate success. Observing a spinal anesthetic being administered by practitioners can give an impression of substantial skills when the procedure is straightforward and successful on the first couple of attempts.

However, when an attempt is not successful after a few attempts, and the anatomy is not clear, this is where the expert approach makes a difference between success and failure. In this video, Dr. Hadzic discusses crucial tips he teaches residents and fellows on how to trouble-shoot spinal anesthesia when the needle constantly encounters osseous structures and makes access to the intrathecal space difficult.

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[Hsa]

I was having trouble with my spinals lately. After I’ve watched this video I could be able to detect the problem with my approach and once I detected, it was just a breeze to solve it. Thank you so much this video saved me so much time!

[gezygiwangkancana]

Such a neat reminder for daily practice even for a ln experienced anesthesiologist

[vinodsmita]

This is the most common problem we face, facing the bone.Thank you

[Motivational.Quotesk]

All this is true.
There is also another scenario : the needle is between the spinous processes but it touches the superior or the inferior one.
In this case the solution is the paramedian approach.

[sergiodiaz]

Huge help for an anesthesia resident!!

[sovereign]

I'm matching in Anesthesia in ~1 week. Awesome vids! Thank you.

[АнараАжикеева-фи]

Thank you very much ! But could you please do this video with the subtitles 🙏🙏🙏

[polly]

I really love tips and tricks for troubleshooting! Thank you sir!

[jakirhossain]

Sir
Do you have any needle preference to overcome difficult spinal in between quincke and sprotte ?
If it is, would you tell me why ?

[kavyarajagopalan]

Hello sir can u discuss abt the troubleshooting in paediatric ( especially infants ) femoral central venous catheterisation…

[poonam]

It Cleared my concept.. thank you a lot sir

[driceman]

Thank you sir... Very useful tips... Which is ur preferred route median or paramedian?

[DrProfX]

Dr. Hodzic, I love how simply you explain this stuff - I’m not even an anesthesiologist, but now I’d want to be one!😂😎👍

[ibrahimhawaty]

What about the positioning sir ? Does these piece of advice work, even there is no proper position of the patient?

[rehanaferoze]

Can I use 25G pencan without introducer. My success rate is significantly reduced since I have started using introducer.
Previously i was using quincke without introducer. 25G

[sweetgalcindy]

I just had a surgery where they used an Epidural on me to help control the pain after surgery well I woke up from surgery my legs was pale and I couldn't move them or my toes so they pulled the Epidural out well I got a very bad headache for a few days but the day I was to go home it wasn't as bad well at home I was given shots to give myself a blood thinner soon as I started taking them by the second day my headache was back.. they tried to do a blood patch on me but had a hard time getting between the bone they tried 5 times the pain of him digging hurt so bad I passed out from it but they got it on the fifth try.. I have 6 big holes in my back where they tried, never again will I let any Dr put a needle any where near my back.. I had 2 kids with out a Epidural and I'm glad I did not.. was so sick from the pain they put me through and the digging of the bone trying to get that big needle in .. should of given me something to relax be before hand because I am good with pain but I never felt anything as bad as that pain in my life time...

[alberteuh]

I have another one for you! It happened to me now 3 times, I'm fully inserted with the needle and have checked every 0.3 cm or so presence of CSF but sometimes even fully inserted I cannot tap anything. Where am I ? How can this be that starting on the midline and being fully inserted I don't reach CSF ? Thanks a lot !

[ymc]

I love your videos btw. Thanks for making these. I find that when I teach novices to withdraw the needle to subQ tissues first and then redirect, they tend to make too big of an adjustment to the angle. I constantly have to correct that tendency. Having said this, I admit I don’t know the skill level of your intended audience for this video. Ideally, I’d like to be able to send all my learners to your channel, so I hope you’ll consider making a video that breaks down the steps further. Thanks for what you do!

[ThangNguyen-ntbw]

Please add english subtitles for these videos 🙏🙏🙏. Thank u so much

[rolandbailey]

How do you know when you are in the Wright place. Ie. The space. Without hitting and damaging the nerves.. I am not talking about the spinal nerves but the nerves below. Where you inject the anesthetic. You don't use ultrasound to guide you. I will have a knee replacement. So I'm wondering how safe is it.