0:56 = Video of paraspinous approach in sitting position 2:52 = Step-by-step walkthrough 5:51 = Lateral decubitus position 7:08 = Video of paraspinous approach in lateral position 9:25 = Final tips 10:22 = Anatomy of spinous processes 12:55 = Obesity 14:04 = Scoliosis
Thank you very much for this video. It is unfortunate that links to other videos ( like video about LP in a scoliotic patient) are not "real" links, that is - you cannot click on it and transit to the next video. They are also cannot be copied with copy-paste function as it is just a part of the image on the screen. To access the desired video one would have to write that nonsense sequence of letters and numbers down and then type it all into a browser line, which is a cumbersome task in itself. It would be helpful then to include these links down below so it would be easier to access. Thanks in advance!
I’m glad to hear that they are proving useful! My only goal is to help fellow practitioners go from strength to strength with their techniques, and improve the care we deliver to our patients as a result. Best wishes!
Thank you! I am a nurse anesthesia resident and I have been doing paramedian spinals the past few weeks. This takes my understanding of it on a higher level.
I use the same basic paraspinous technique. The thoracic SPs are so narrow, that the needle looks as though it is advancing in midline - and this is really what happens every time someone employs a "midline" thoracic epidural insertion technique. Starting too far lateral and using a large lateral-to-medial angle is what gets people into the pleural space on the other side, or getting false LOR as they cross the midline into the paravertebral muscles on the other side.
@@KiJinnChin this is great insight. how much of a cephalad angulation do you usually find is necessary in the paraspinous approach for thoracic epidural? any chance you could post a demonstration video of your thoracic epidural technique?
Thank you for your response! +1 to the video request, that would be amazing. I regard thoracic epidurals as one of the most difficult procedures we do in OR.
Yes that would certainly be challenging! This is where ultrasound imaging is really helpful to identify the open spaces and where they are, when the normal surface landmarks are obscured. See the video on US imaging in obese.
0:56 = Video of paraspinous approach in sitting position
2:52 = Step-by-step walkthrough
5:51 = Lateral decubitus position
7:08 = Video of paraspinous approach in lateral position
9:25 = Final tips
10:22 = Anatomy of spinous processes
12:55 = Obesity
14:04 = Scoliosis
Thank you very much for this video.
It is unfortunate that links to other videos ( like video about LP in a scoliotic patient) are not "real" links, that is - you cannot click on it and transit to the next video. They are also cannot be copied with copy-paste function as it is just a part of the image on the screen.
To access the desired video one would have to write that nonsense sequence of letters and numbers down and then type it all into a browser line, which is a cumbersome task in itself.
It would be helpful then to include these links down below so it would be easier to access.
Thanks in advance!
Dr. Ki-Jinn Chin, the simplicity with which you have explained this procedure is simply awesome. Thank you very much. An anaesthetist from the UK.
Many thanks from rural North Dakota! Your videos have helped me to improve my technique significantly. Your explanations are absolutely priceless!
I’m glad to hear that they are proving useful! My only goal is to help fellow practitioners go from strength to strength with their techniques, and improve the care we deliver to our patients as a result. Best wishes!
@@kijinnchin2411 Your thinking are like of Amazing Super power..God
Your videos are simply great. I am addicted to these videos.
Thank you very much doctor for sharing your knowledge and teaching us. Greetings from México.
Thank you so much for spreading techniques. So useful! Greetings from Brazil
Excellent Explained thank you Professor for uploading this education material which helps Anesthesiologist and Patients as well. Greeting from Yemen
Superb as usual Dr Chin. Your videos make life easy. Thank you
Thanks a lot u are providing a great knowledge with ur videos . It will be helpful to many anesthesiologist worldwide
Beautifully explained
Sir please make video for proper positioning in lateral and sitting position for spinal anaesthesia
Very useful, very well explained thank you 🙏
Thank you! I am a nurse anesthesia resident and I have been doing paramedian spinals the past few weeks. This takes my understanding of it on a higher level.
excellent, I want to thank you for your effort to teach. Congratulations from Argentina.
Thanks very much from Italy.
Thanks so much, the video was on point. Greetings from Nigeria
I'll essay your pearls this week, surely they yield success, thanks!
Excellent
Great lecture
Thank you very much for this video!
@kijinnchin - Very neatly illustrated & explained.Excellent teaching material. Thank you Sir.
Beautiful sir🙏🙏👍
Thanks very much. It is very helpful
Thank youuu, easy to understandd doc
Hello sir.. what about Paraspinous approach with extended leg- position with patient in lateral position..
ua-cam.com/video/dyGCfsrme_0/v-deo.html
It works very well. It’s pretty much my standard approach to hip fractures. I never try to flex them at the broken hip.
Did you go through the UA-cam link sir.. if so did you like it..If you have published this technique can you send the link sir..
Thanks for the reply sir
@kijinnchin Thank you, incredibly useful. For thoracic epidurals do you use the same technique or do you make any adjustments?
I use the same basic paraspinous technique. The thoracic SPs are so narrow, that the needle looks as though it is advancing in midline - and this is really what happens every time someone employs a "midline" thoracic epidural insertion technique. Starting too far lateral and using a large lateral-to-medial angle is what gets people into the pleural space on the other side, or getting false LOR as they cross the midline into the paravertebral muscles on the other side.
@@KiJinnChin this is great insight. how much of a cephalad angulation do you usually find is necessary in the paraspinous approach for thoracic epidural? any chance you could post a demonstration video of your thoracic epidural technique?
Thank you for your response! +1 to the video request, that would be amazing. I regard thoracic epidurals as one of the most difficult procedures we do in OR.
I've just posted a video on thoracic epidural as requested! ua-cam.com/video/DrAO5kJyfeE/v-deo.html
@@KiJinnChin
ua-cam.com/video/Ui7rKs5fyYg/v-deo.html
Then repeat the same with an African lordosis back of a lady with BMI of 42. Nice video, though.
Yes that would certainly be challenging! This is where ultrasound imaging is really helpful to identify the open spaces and where they are, when the normal surface landmarks are obscured. See the video on US imaging in obese.
And that’s why I refuse spinals, “probing with the needle”. No thanks I’ll stick with the general.