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Related Concept Videos

Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

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Related Experiment Video

Updated: Jul 11, 2026

Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs
09:23

Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs

Published on: December 7, 2012

Isobaric spinal anesthesia for paraplegic patients.

H K King1, C Johnson, L Wood

  • 1Department of Anesthesiology, King/Drew Medical Center, Los Angeles, CA 90059, USA.

Acta Anaesthesiologica Sinica
|July 17, 1999
PubMed
Summary

Spinal cord injury (SCI) patients at risk for autonomic hyperreflexia (AH) present anesthetic challenges. Isobaric spinal anesthesia (ISA) effectively prevented AH in 13 SCI patients during surgery.

Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Critical Care Medicine

Background:

  • Patients with spinal cord injury (SCI) above T6-7 are susceptible to autonomic hyperreflexia (AH), complicating anesthesia management.
  • Current anesthetic techniques for SCI patients lack consensus and have variable success rates in preventing AH.
  • Neuraxial anesthesia is effective for blocking afferent pathways but carries risks of high block and hypotension in SCI patients.

Purpose of the Study:

  • To evaluate the efficacy and safety of isobaric spinal anesthesia (ISA) for managing anesthesia in patients with spinal cord injury (SCI).
  • To determine if ISA can prevent autonomic hyperreflexia (AH) in SCI patients undergoing surgical procedures.

Main Methods:

  • A retrospective review of 13 SCI patients who received isobaric spinal anesthesia (ISA) between 1982 and 1997.

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  • Analysis of perioperative autonomic hyperreflexia (AH) incidence in SCI patients who underwent surgery under ISA.
  • Assessment of anesthetic management and potential complications, including hypotension and block level control.

    • Main Results:

    • None of the 13 SCI patients experienced autonomic hyperreflexia (AH) during the perioperative period.
    • Four patients in the study group had a previous history of autonomic hyperreflexia (AH).
    • Isobaric spinal anesthesia (ISA) allowed for predictable anesthesia levels, mitigating risks associated with high block and hypotension.

    Conclusions:

    • Isobaric spinal anesthesia (ISA) is a safe and effective anesthetic technique for patients with spinal cord injury (SCI).
    • ISA significantly reduces the incidence of autonomic hyperreflexia (AH) in the perioperative period for SCI patients.
    • The predictable nature of anesthesia level with ISA makes it a valuable option for managing SCI patients undergoing surgery.