So tomorrow I will be doing a total knee replacement. Which will entail putting in an epidural. Putting in an epidural is a very technical skill. Any minor perturbations of the norm can have pretty serious consequences. An intrathecal or intravascular injection of what is thought to be an epidural injection can cause a high spinal, where the patient will become unconscious and unable to protect their airway or breath on their own, so the patient will need to be intubated, or in the case of an intravascular injection, can cause recalitrant arrythmmias, the classic being the case of bupivacaine toxicity which can be resistant to atropine.
Anesthesia residency involves early hours and often we are here late. It also requires a lot of reading.
I really should be reading, so I am off to read my Baby Miller, the outpatient surgery chapter.
