Neuraxial Ultrasound and Epidural Blood Patch for Post-dural Puncture Headache
Fatine Karkri, MD; Lauren Blake, MD; Brendan Carvalho, MBBCh, FRCA, MDCH, FASA
Stanford University School of Medicine
This video demonstrates a stepwise technique for performing an autologous epidural blood patch (EBP) to treat post-dural puncture headache (PDPH). The video covers identification of the target interspace, skin cleaning, local anesthesia infiltration, epidural needle placement using loss-of-resistance technique, aseptic collection of autologous blood, controlled injection into the epidural space, and immediate assessment of EBP effect. Indications, contraindications, expected immediate responses, and troubleshooting (including repeat EBP and alternative interventions) are discussed. The technique shown aims to maximize efficacy and enhance safety, and is applicable to PDPH after dural puncture from spinal anesthesia or inadvertent dural puncture during epidural placement.
Spinal Anesthesia for Ambulatory Hip and Knee Arthroplasty Procedures
Bruna Castro de Oliveira, MD
Massachusetts General Hospital
This educational video article details the technique of spinal anesthesia administration for total hip and knee arthroplasty. The presentation details key procedural elements, including anatomical landmarks, midline and paramedian techniques for spinal placement, equipment for spinal anesthesia, patient positioning and preparation, and local anesthetic selection. Spinal anesthesia offers distinct advantages for outpatient arthroplasty, including rapid onset, favorable operative conditions, and facilitation of same-day discharge. The video serves as a practical educational tool that reinforces evidence-based anesthetic practice and supports the continued advancement of safe, efficient care in ambulatory joint replacement surgery.
Neuraxial Ultrasound and Spinal Anesthesia for Cesarean Delivery
Fatine Karkri, MD; Lauren Blake, MD; Brendan Carvalho, MBBCh, FRCA, MDCH, FASA
Stanford University School of Medicine
This video provides a step-by-step demonstration of preprocedural neuraxial ultrasound for lumbar neuraxial procedures. The film shows probe selection and orientation, sonoanatomy landmarks (sagittal and transverse views), measurement of skin-to-posterior complex depth, and skin marking. Indications and evidence for improved procedural accuracy and reduced needle passes are discussed. The technique is applicable to routine obstetric neuraxial procedures and is especially useful in patients with challenging surface landmarks or a history of difficult neuraxial placement.
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