Spinal anesthetics in pre-op


Our hospital is trying this new thing for our total knee replacements to expedite turnovers, etc. - the anesthesiologist is doing the spinal anesthesia in the pre-op and we, the pre-op nurses are supposed to monitor the patients after the spinal. The anesthesiologist keeps saying that he is nearby and available. I get this flutter in my chest and stomach telling me that this is a bad idea. Anybody have any policies regarding this in your hospital? Any thoughts?


155 Posts

Specializes in PACU,Trauma ICU,CVICU,Med-Surg,EENT. Has 31 years experience.


Anesthesia does quite a number of spinals here - but only in the OR. They're not even done in the regional block area. To do them in a preop area seems foolhardy to me,at best. The potential problems post-spinal anesthetic (sorry for the alliteration!) makes me cringe,too,at the thought. Not to mention how upsetting it would be to the other preop pts waiting in the same general area if complications arose.

Maybe your Perianesthesia program is different from mine- here,the preop RNs do not float through PACU or the OR,and they don't have to have an ICU course or ICU work experience as we do, so preop would never see anything like this. Preop seems an inappropriate place to perform and then hold these pts in...

Has the anesthetist arranged with your nurse manager to alter staffing to ensure constant observation of these pts until they go to the OR? If not,there's no way on this earth I'd agree to it.

Do your colleagues share your trepidation? (which,by the way,I TOTALLY understand)

Have you approached your nurse manager with your concerns?

I think you're spot-on to be concerned about this plan. Let us know how it works out? :)


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