Відео

Make sure you are sedated before the block begins, my first on made me feel like lighting had struck my leg, and another one my shoulder, but when I told the third anesthesiologist his the next 3/5 went well. Its been months and I still have sharp pain, strange numbing in my lips and toes?> Mr Dr stuck me over a dozen times and was angry he missed so many IV locations. Right now I have 11 + bruises on arteries after He kept telling me He never misses….after asleep he went on to miss many IV location as I need blood in separate locations. I ended up with a pic line and a subclavian ! Ouch

Thanks for the video! Always enjoy them. Would be cautious about sterility if one were to touch iliac crests during this procedure. While there was a wide prep, the provider's fingers were incredibly close to the non-prepped area as seen from 3:46-3:59. Others who follow your videos may not appreciate the risk of glove contamination when touching landmarks outside the sterile field. Thanks!

What about Epidural space?!

Great video as always! Usg isnt used for difficult spinal in our institute. Looking forward to using your techniques next time

I appreciate this explanation. Thank you.

Why did u take out the stylet midway? It's role is to prevent occlusion of the needle, we only take it out after seeing CSF at the hub of the needle (seems safer).

This will make a shift in my practice in suspected difficult spinal patients . I will start to use ultrasound for that. I need to read your comments regarding the removal of introducer then further advances of spinal needle without introducer from your experience view of points.

No introducer? Thanks for the content!

Thank you for the excellent video. I would like to know if wearing a sterile gown is no longer deemed necessary before performing a sub arachnoid block. I work at a teaching institute and seem to be the only one insisting on washing of hands, applying sterile fenestrated drapes and wearing sterile gowns. Your own standards of spinal anesthesia mention the same. Are those precautions considered outdated now?

I have had 2 shoulder surgeries under brachial plexus blocks, colorectal surgery under Exparel nerve block, and nose surgery with excellent local anesthesia in addition to general anesthesia. I was surprised how much less pain I had compared with surgeries that didn't include nerve blocks (yikes!! 😬). When my dad was still working as a dentist, he had similar success with nerve blocks controlling post-op pain well enough that patients required little-no opioids for surgical pain. Nerve blocks are pretty impressive and now I wonder how those will be done as I get ready for an organ transplant.

Sir please explain how to calculate epidural depth 🙏 thank you very much for very good demo 🙏🙏

@NYSORA DR, PLEASE TELL ME WHAT IS THE NAME, OF THAT TOURNIQUET THE PACIFIC TOURNIQUET THAT YOU'RE USING, I NEED TO GET THAT SO BADLY FOR WORK I REALLY LIKE IT.

@NYSORA WHAT IS THE NAME OF THAT TOURNIQUET, THAT'S A PATIENT HAD ON, RIGHT AT ABOUT A MINUTE AND 25 SECONDS, BEFORE YOU/OR SOMEONE ELSE, STARTED WRAPPING THEM UP TO FORCE THE BLOOD DOWN, TO GET AT LEAST EVERYTHING TO POP UP it was about @1:05, and I will love that wrapping up technique, I never thought about it, but that's covers like using like 10 tourniquets at one time, another thing I try to make sure they're warm, I usually put hot water and gloves, and then tie them up, or put heat compressors on them, those are in packets that you just pop,

What is the name of that tourniquet, that they were using, before they started even putting on the blue s bar and what they called it I think, but I really want that tourniquet, and then you cannot order a IB machine, but I did find a vein finder online, for people without veins, so that I'm not poking them all the time because I feel their pain, I'm not a drug addict, nor have I ever been, that is a IV drug addict, and now different people have their own opinions about what a drug addict is, and who they are, I don't worry about anybody else's but mine, and as long as I'm not doing something that is making my life a living hell, where I cannot be the parent, the nurse, and make rational decisions, or am hurting my finances, backstabbing my life partner, then I am okay, so with that being said I have always taken place and cannibal using (AKA smoke, vape, & eat marijuana), but we finally live in a day and time, to where it is perfectly legal for me to do that, and I am a great judging character, to know I should not be doing that point blank, PERIODT when I'm about to stick someone, or taking care of someone's mother father, child, or being under the influence driving, or at work whatsoever, as well as being a parent, I can't be talking to teachers, making sure my kids are making great decisions, me helping them with those decisions, if I'm stoned, and I cannot B1 with my partner's mind, and the intimate fashion, on what's going on with you, what's going on at work, how was your day, how is things going with our children, is anything going on you need to talk about at work, need to get any pressure off, anything going on between you and the kids, that you need me to step in, and help you with, or do you feel a certain way, about something that I am allowing them to do, and you don't feel the same about it, don't feel like you're back up, and how is things on your side of the family, and you think you need to talk about on the end, anyone's birthday coming up, do you need me to be on top of, with the plans for that, do I need to be picking up or out gifts and etc, and then on my off days, you know after I have checked in with everyone done all my duties, then I'm free to do whatever I want to do, and take my dog, go for a job go to the park,and come right back home in 5 minutes, after I realized I was just literally been sitting at the park and playing with my dog, for 3 hours, and start dinner😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂 so I NEVER EVER allow, those two different lifestyles, Cross in each other's lane, on this freeway of my life, and that is just being for real., but anyhow back to the vein finder I was talking about, it was like $200, it's a red small flashlight, and it is lights up green when you're over a vein, it has this little thing that you look through with the one i, and the lights has to be off, and then another colors that you choose, it tells you how deep the vein is, so whether it's deep, but superficial enough, for you to get it with the regular tools that you have, or is it too deep for regular IV needles, but deep perfectly enough, to do like a midline or a, that nurses still can do, because you don't have Ivy equipment I don't know why, when they're on the floors, and ultrasound ivs, do not last long hardly ever, because the veins are so deep, the needles are so long, if they get a kink in them, it's not like you can just pull it out see the king can try to fix it, by floating it back in, you will have to force so much out, that it will be impossible to float back in, so if I'm doing this up on the floor to lose somebody with no veins, and I use my vein finder, I just tried to put a midline in 🤷‍♂️

suggestion : use "screen in screen" for those videos. i am more intrested in USG image and in the corner we would then see a marker action.

Isn’t she move all the debris to the intrathecal area ?

Inserting the entire needle and not appreciating the appearance of spinal fluid increases the risk of spinal cord puncture!!!

Is it a 22g? Why is entry without stylet?

Thank you so much for the super explanation. It is much appreciated!👌🏼

I just got this for acl surgery. It has been almost 24 hours since my surgery and I have literally had no pain besides for my hamstring where the took the graft from. They said it will last 2-4 days :)

The other problem with 45° approach is once you enter the artery, drop your angle, thread your wire, advance your catheter, then you lay your catheter flat against the skin, the cath effectively makes a sort of S shape under the skin, it will kink, If not initially, as the catheter warms up to body temp and gets softer, it will definitely kink off later, or at least give you a dampened waveform. Great video Dr. H, as always

If you start phenylephrine infusion .it will be wonderful and there will be no Hypotension either in GA or Spinal

The best teacher

I was terrified to get an epidural (kinda still am) with my firstborn. The anesthesiologist I had seemed really strange and talked like some surfer dude, so I didn’t have a ton of confidence in him, but I was in such excruciating pain I felt like I needed it. The morphine given to me only lasted 10 minutes since they limit you due to baby. I had no idea or could tell that anything was hitting bone until the anesthesiologist said, “Oh, I’m hitting bone.” I tried to stay still as possible but in my mind I was like, “OMG WHAT?!” My second epidural for my secondborn was much better and I felt way more relief from the meds. with that one. Not sure if she just did a better job or what. Now I’m about to have my third baby and am nervous again for this. My mom knew someone she worked with back-in-the-day that had some kind of partial paralyzation from an epidural. I’ve heard they’ve improved at least since then but anything dealing with my spine makes me nervous!

Isn't saphenous nerve is also blocked in ankle technique?

2 cm 6 cm 8 cm inside different scenarios, very beautifully explained

Thank you for the video! My sister was treated terribly for consuming marijuana (just in general not beforehand) and she was treated as if she was gross or a bad kid. Very unprofessional

I had an iv before and it was successful

This approach for scatic n block I think not enough it bypass posterior cutaneous n of the thigh you need to go more higher gluteal approach plus u need to block also lateral cutaneous n of the thigh and obturator

Had it done twice painless.

Had both hips done.....Had thus done each time was totally painless

Am interested

I hv experienced this,so painful 😭😭