Regional anaesthesia: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Regional anaesthesia

Sample item

A spinal anaesthetic is performed in the sitting position with hyperbaric bupivacaine and the patient remains seated for several minutes before lying supine. What is the expected effect?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Predominantly sacral and low lumbar block with sparing of higher levels

Hyperbaric solutions are denser than CSF and settle with gravity. In the sitting position the drug pools in the lower lumbar and sacral subarachnoid space, producing a saddle-type block, as used in perineal surgery. Placing the patient supine promptly lets the drug spread cephalad over the thoracic kyphosis.

Option by option

  • A. Block spreading to the cervical segments

    Cephalad spread is expected if the patient is made supine immediately or given large doses.

  • B. Unilateral right-sided block

    Unilateral block arises with lateral positioning, not sitting.

  • C. Predominantly sacral and low lumbar block with sparing of higher levels (correct)

    Correct. The dense drug settles caudally with the patient sitting, giving a saddle block.

  • D. No block at all

    Hyperbaric bupivacaine gives dependable block in this position.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Predominantly sacral and low lumbar block with sparing of higher levels. Hyperbaric solutions are denser than CSF and settle with gravity.

Why is "Block spreading to the cervical segments" not the answer?

Cephalad spread is expected if the patient is made supine immediately or given large doses.

Why is "Unilateral right-sided block" not the answer?

Unilateral block arises with lateral positioning, not sitting.

Why is "No block at all" not the answer?

Hyperbaric bupivacaine gives dependable block in this position.

What concept does this question test?

It tests Regional anaesthesia in Anaesthesia. In the sitting position the drug pools in the lower lumbar and sacral subarachnoid space, producing a saddle-type block, as used in perineal surgery. Placing the patient supine promptly lets the drug spread cephalad over the thoracic kyphosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Regional anaesthesia?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.