[The current state of spinal anesthesia in urologic interventions]

It is reported on the experiences of several years in 9,400 spinal anaesthesias in the urology in patients at an advanced age. Still at present the spinal anaesthesia has a dominating position in the urological intervention. Despite modern and differenciated anaesthetic methods the importance of the spinal anaesthesia is by no means reduced for most urological interventions, particularly for the transurethral operation technique, but it rather increased during the last years by the new local anaesthetics, by the development of thinnest spinal needles, but also the increased knowledge of the dangers of general anaesthesia. In urological diagnostics and therapy the spinal anaesthesia has still its full right and is less toxic for the patient and has less severe complications than the general anaesthesia. However, prerequisites for its use are: a) mastery of technique b) full assent of the patient c) psychic guidance of the patient during the whole duration of the intervention and d) balanced pre-, intra- and postoperative substitution of the volume e) overcoming of the established opinion that the spinal anaesthesia has a particular depressing effect on circulation and frequently causes post-spinal headache.