Anesthetic considerations in the patient with acute spinal cord injury

The extent and level of the spinal cord injury as well as the presence of associated injuries affects the choice of anesthetic agents, techniques, and monitoring modalities. The role of the anesthesiologist is not limited only to the administration of anesthesia, but frequently his active participation in the team approach care of the spinal cord injury patient is needed during preoperative treatment and postoperatively in the ICU setting. Understanding of the pathophysiologic changes related to the spinal cord injury helps in the delivery of better anesthetic care for severely handicapped patients.