Regional Anaesthesia: Complications and Contraindications MCQs

The thumb corresponds to dermatome C6, the second and middle fingers correspond to dermatome C7, and the fourth and little fingers correspond to dermatome C8. Reference: Barash: Clinical Anesthesia, ed 8, p 920

Transient neurologic syndrome (TNS), formerly called transient radicular irritation (TRI), occurs most commonly after spinal anesthesia with lidocaine (Xylocaine). Symptoms include back pain that develops after the block resolves and radiates to the buttocks and legs. The pain is not associated with motor or sensory loss or electromyographic changes. It can be severe, requiring hospital admission of outpatients, and typically resolves within 1 to 4 days. It appears to occur more commonly when outpatients are operated on in the lithotomy position and appears to be less likely when patients are pregnant Reference: Chestnut: Chestnut's Obstetric Anesthesia, ed 5, p 756; Suresh: Shnider and Levinson's Anesthesia for Obstetrics, ed 5, pp 112-113.

In patients who may experience a "wet tap" during placement of an epidural, conservative therapy should include bed rest and plenty of fluid intake, including caffeine; food diet low in fiber and stool softeners are encouraged to prevent straining. Leakage of CSF can lead to a reduction in intracranial pressure and post dural puncture headache chances are high since the epidural needle is an 16/18 G needle . Reference: Morgan and Mikhail's clinical anesthesiology 6th edition pg 992.