Abstract
The administration of a local anesthetic in the subarachnoid space acts on the spinal roots causing reversible blockage of these nerves. It is a classic technique that has been refined over time and expanded in its practical applications. The development of new drugs and special techniques has been crucial and has greatly influenced the use of spinal anesthesia and its indications.
Keywords
- Local Anesthetic
- Spinal Anesthesia
- Local Anesthetic Solution
- Subarachnoid Space
- Spinous Process
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References
Casati A, Vinciguerra F. Curr Opin Anaesthesiol. 2002;15:543–51.
Reina MA, De Leon Casasola O, Lopez A, et al. The origin of the spinal subdural space: ultrastructure findings. Anesth Analg. 2002;94:991–5.
Liu SS, McDonald SB. Current issues in spinal anesthesia. Anesthesiology. 2001;94:888–906.
Carpenter RL, Hogan Q, Liu SS, et al. Lumbar cerebrospinal fluid volume is the primary determinant of sensory block extent and duration during spinal anesthesia. Anesthesiology. 1998;89:24–9.
Greene NM. Physiology of spinal anaesthesia. 3rd ed. Baltimore: Williams & Wilkins; 1981.
Mulroy MF, Larkin KL, Hodgson PH, et al. A Comparison of spinal, epidural and general anaesthesia for outpatient knee arthroscopy. Anaesth Analg. 2000;91:860–4.
Mulroy MF, Salinas FV, Larkin KL, Polissar NL. Ambulatory surgery patients may be discharged before voiding after short-acting spinal and epidural anesthesia. Anesthesiology. 2002;97:315–9.
Salinas FV, Sueda LA, Liu SS. Physiology of spinal anaesthesia and practical suggestions for successful spinal anaesthesia. Best Pract Res Clin Anesthesiol. 2003;17(3):289–303.
Kamphius ET, Ionescu TI, Kuipers PWG, et al. Recovery of storage and emptying functions of the urinary bladder after spinal anesthesia with lidocaine and bupivacaine in men. Anesthesiology. 1998;88:310–6.
Sessler DI. Mild perioperative hypothermia. N Engl J Med. 1997;336:1730–7.
Sessler DI. Perioperative heat balance. Anesthesiology. 2000;92:578–96.
Macario A, Dexter F. What are the most important risk factors for a patient´s developing intraoperative hypothermia? Anesth Analg. 2002;94:215–20.
Frank SM, EI-Rahmany HK, Cattaneo CG, Barnes RA. Predictors of hypothermia during spinal anesthesia. Anesthesiology. 2000;92:1330–4.
Ready LB, Cuplin S, Haschke RH, et al. Spinal needle determinants of rate of transdural fluid leak. Anesth Analg. 1989;69:457.
Hodgson PS, Liu SS, Batra MS, et al. Procaine compared to lidocaine for incidence of transient neurologic symptoms. Reg Anesth Pain Med. 2000;25:218.
Liu SS, Ware PD, Allen HW, et al. Dose-response characteristics of spinal bupivacaine in volunteers. Clinical implications for ambulatory anaesthesia. Anesthesiology. 1996;85:729–36.
Pitkanen M, Rosenberg PH. Local anaesthetics and additives for spinal anaesthesia – characteristics and factors influencing the spread and duration of the block. Best Pract Res Clin Anaesthesiol. 2003;17(3):305–22.
Kozody R, Palahnuik RJ, Cummings MO. Spinal cord blood flow following subarachnoid tetracaine. Can Anaesth Soc J. 1985;32:23–9.
Kozody R, Ong B, Palahnuik RJ, et al. Subarachnoid bupivacaine decrease spinal cord blood flow in dogs. Can Anaesth Soc J. 1985;32:216–22.
Kozody R, Palahnuik RJ, Biehl DR. Spinal cord blood flow following subarachnoid lidocaine. Can Anaesth Soc J. 1985;32:472–8.
Sakura S, Sumi M, Sakaguchi Y, et al. The addition of phenylephrine contributes to the development of transient neurologic symptoms after spinal anesthesia with 0.5% tetracaine. Anesthesiology. 1997;87:771–8.
Moore JM, Liu SS, Pollock JE, et al. The effect on epinefrine on small-dose hyperbaric bupivacaine spinal anesthesia: clinical implications for ambulatory surgery. Anesth Analg. 1998;86:973–7.
Sheskey MC, Rocco AG, Bizarri-Scgmid M, et al. A doses response study of bupivacaine for spinal anaesthesia. Anesth Analg. 2003;97:589–94.
Van Zundert AA, Grouls RJ, Korsten HH, et al. Spinal anesthesia. Volume or concentration: what matters? Reg Anesth. 1996;21:112.
Urmey WF, Stanton J, Bassin P, et al. The direction of the Whitacre needle aperture affects the extent and duration of isobaric spinal anaesthesia. Anesth Analg. 1997;84:337–41.
Pitkanen M, Haapaniemi L, Tuominem M, Rosenberg PH. Influence of age on spinal anaesthesia with isobaric o, 5% bupivacaine. Br J Anesth. 1984;56:279–384.
Cameron AE, Arnold RW, Ghorisa MW, Jamieson V. Spinal analgesia using bupivacaine 0.5%. Variation in the extent of the block with patient age. Anesthesia. 1981;36:318–22.
Pitkanen M. Body mass spread of spinal anesthesia with bupivacaine. Anesth Analg. 1987;66:127–31.
McCulloch WJ, Littlewood DG. Influence of obesity on spinal analgesia with isobaric 0, 5% bupivacaine. Br J Anesth. 1986;58:610–4.
Arndt JO, Bomer W, Krauth J. Marquardt. Incidence and time course of cardiovascular effects during spinal anesthesia after prophylactic administrations of fluids and vasoconstrictors. Anesth Analg. 1998;87:347–54.
Mojica JL, Melendez HJ, Bautista LE. The timing of intravenous crystalloid administration and incidence of cardiovascular side effects during spinal anaesthesia; the results from a randomized controlled trial. Anaesth Analg. 2002;94:432–7.
Chan WS, Irwin MG, Tong WN, Lam YH. Prevention of hypotension during spinal anesthesia for caesarean section: ephedrine infusion versus fluid preload. Anesthesia. 1997;52:908–13.
Pollard JB. Cardiac arrest during spinal anaesthesia: common mechanisms and strategies for prevention. Anesth Analg. 2001;92:252–6.
Furst SR, Reisner LS. Risk of high spinal anesthesia following failed epidural block for caesarean delivery. J Clin Anesth. 1995;1:71–4.
Horlocker TT, Wedel DJ, Benzon HT, et al. Regional anesthesia in the anticoagulated patient: defining the risk (the second ASRA consensus conference on neuroaxial anesthesia and anticoagulation). Reg Anesth Pain Med. 2003;28:172–97.
Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy. American Society of Regional Anesthesia and Pain Medicine Evidenced-Based Guidelines (Third Edition). Reg Anesth Pain Med. 2010;35(1):64–101.
Pollock JE. Neurotoxicity of intrathecal local anaesthetics and transient neurological symptoms. Best Pract Res Clin Anesthesiol. 2003;17(3):471–83.
Kane RE. Neurologic deficits following epidural or spinal anesthesia. Anesth Analg. 1981;50:150–61.
Rigler ML, Drasner K, Krejcie TC, et al. Cauda equina syndrome after continuous spinal anesthesia. Anesth Analg. 1991;72:275–81.
Cosar A, Yetiser S, Sizlan A, et al. Hearing impairment associated with spinal anaesthesia. Acta Otorlaryngol. 2004;124:1159–64.
Lybecker H, Andersen T, Helbo-Hansen HS. The effect of epidural blood patch on hearing loss in patients with severe PDPH. J Clin Anesth. 1995;7:457–64.
Harrington BE. Postural puncture headache and the development of the epidural blood patch. Anesth Pain Med. 2004;29:136–63.
Spencer HC. Postdural puncture headache: what matters is technique. Reg Anesth Pain Med. 1998;23:374–9.
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Gudin, M.T., López, R., Estrada, J., Ortigosa, E. (2012). Neuraxial Blockade: Subarachnoid Anesthesia. In: Kaye, A., Urman, R., Vadivelu, N. (eds) Essentials of Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1013-3_11
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DOI: https://doi.org/10.1007/978-1-4614-1013-3_11
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