Spinal anesthesia: How to use Guide Needle - Regional Anesthesia Crash Course with Dr Hadzic

Spinal anesthesia: How to use Guide (Introducer) Needle. Regional Anesthesia Crash Course with Dr Hadzic

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[YouGotPropofol]

Most people saying they saw CSF coming out of the introducer needle are seeing their local injection flowing out, not CSF. I generally don't "hub" the introducer needle as every anatomy is different and I'm sure plenty of anatomy out there with SAS at or less than 3cm from ligament, but still I use the introducer and insert the introducer to about 80-90% of its length. If after that if my spinal needle (pencan) is not advancing or meeting too much resistance, then I will take the spinal needle out and then hub the introducer to 100% and try again. I have actually had many patients who have thick skin and so much sub-q fat that the introducer wont even engage with the ligament. Or once it engages the skin/fat actually pull it back out. This can also be a problem. We then use a sterile and longer 5" hypodermic needle to replace the shorter introducer needle.

[MohamedIbrahim-qtmz]

Paramedian approach without introducer is so much easier and faster, and you aren't in need to give local anesthesia and to use double puncture.

[JustPeaceLoveAndKindness]

the shallow placement of the introducer needle is fine, as long as you advance the introducer needle along with the spinal needle. That would provide the support that the spinal needle needs to reach deep targets.

[tropiex]

I've done a lot of sa puncures and twice happens that CSF flow freely throw the introducer. So the solution I adopt now is to introduce the introductor for 2 cm and after intoduce the spinal needle haft centimeter beyond the introducer and advace them together!

[stephkera]

Dr Hadzic im about to perform my first spinal today and i am thankful for this tip!

[dudevraj]

I rarely need the introducer. The 24 or 25 G needle can be negotiated through the tough ligament. It just needs practice. Furthermore less patient complains back pain owing to large gauge needle

[mayadayahia]

You meant that I should introduce the whole length of introducer?! I always go paramedian approach and introduce the whole length of introducer unless the pt is so thin

[jimmyramirez]

I’ve been doing this procedure for a while, moreover when using the Whitacre needle. And it’s so recommended for its great success rate. 👍🏻

[jakirhossain]

I always introduce half length as it is easy to redirect.
Ok, sir. Next time I shall correct myself

[drali]

Hello dr
Can u please upload a video about intra articular lidocaine for anterior shoulder dislocation reduction

[benballisat]

The logic in this video doesn’t hold true when performing a spinal anaesthetic in an obese patient where the subcutaneous fat depth may be greater than the length of the introducer. In such cases, the spinal needle is perfectly capable of passing through the ligaments without the aid of the introducer.

[vanyazheleva]

Anyone knows if 30 gauge is enough for reaching and administrating stem cells ?

[DarkoLHS]

Actually I have reached intrathecal space once with introducer in less than 3 cm in one tiny woman for c section. I gave anesthetic through introducer😂 and small irrelevant postpuncture headache occur after two days

[No-xhcs]

I got csf with my introducer before in a thin patient though 😂 definitely be careful

[TsterMr]

The problem with introducers is that they steal some of your potential depth which may be needed in obese patients.

[haliShanna]

2 mistakes I encountered in this video, as I'm just an anesthesia resident. A needle, regardless how tiny it is, NEVER curved in pts tissue.Once you go through the skin, the needle never curve ( at least not like a snake), actually if you support and stabilize the needle with both hand, you will never bend your needle. Yes I am talking abt no introducer method.

Second mistake the video has is, he said that introduced is short enough and no way can reach the subarachnoid space. And thatsbjust a not true. Last week, my attending came to me and told me that in o e of my college spinal, the CSF was dripping from the...INTRODUCER.
Now we have 100 kg man, hey I get it. But if you have 45 kg old lady, that introducer will definitely reach the SAH space. Period.