Local and regional anaesthesia: differential block in spinal 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 · Local and regional anaesthesia: differential block in spinal anaesthesia

Sample item

In spinal anaesthesia, which modality of block extends to the highest spinal level?

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

The answer and the reasoning

C. Sympathetic block

Smaller preganglionic sympathetic B fibres are blocked first, so the sympathetic level is about two segments above the sensory level, and motor block is about two segments lower. This explains the early hypotension.

Option by option

  • A. Light touch and proprioception block

    Touch and proprioception are blocked later and at a lower level.

  • B. Pain block

    Pain block lies about two segments below the sympathetic level.

  • C. Sympathetic block (correct)

    Correct. Sympathetic block rises highest, about two segments above sensory.

  • D. Motor block

    Motor block has the lowest level because of larger fibres.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Sympathetic block. Smaller preganglionic sympathetic B fibres are blocked first, so the sympathetic level is about two segments above the sensory level, and motor block is about two segments lower.

Why is "Light touch and proprioception block" not the answer?

Touch and proprioception are blocked later and at a lower level.

Why is "Pain block" not the answer?

Pain block lies about two segments below the sympathetic level.

Why is "Motor block" not the answer?

Motor block has the lowest level because of larger fibres.

What concept does this question test?

It tests Local and regional anaesthesia: differential block in spinal anaesthesia in Anaesthesia. This explains the early hypotension.

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 Local and regional anaesthesia: differential block in spinal 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.