Related Experiment Video
Updated: Aug 6, 2026
02:02
Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis
Published on: February 24, 2023
Continuous spinal anaesthesia--evolution of a technique
C P Morton1, A F McCrae, J A Wildsmith
1Department of Anaesthetics, Royal Infirmary of Edinburgh, UK.
Annals of the Academy of Medicine, Singapore
|November 1, 1994
Summary
Continuous spinal anesthesia offers renewed potential for peripheral vascular surgery. Optimizing catheter placement and anesthetic properties may mitigate risks like post-dural puncture headache and nerve damage.
Area of Science:
- Anesthesiology
- Neurosurgery
- Vascular Surgery
Background:
- Continuous spinal anesthesia (CSA) is a re-emerging technique facilitated by advanced small-bore catheters for subarachnoid administration.
- Potential complications include technical challenges, post-dural puncture headache, and local anesthetic maldistribution, which may lead to caudal equina syndrome.
Purpose of the Study:
- To review the established technique of continuous spinal anesthesia.
- To present original research assessing CSA's utility in peripheral vascular surgery.
- To explore methods for mitigating CSA-related complications.
Main Methods:
- Review of existing literature on continuous spinal anesthesia.
- Conducting original studies evaluating CSA in patients undergoing peripheral vascular surgery.
- Investigating optimal catheter tip placement (lumbar apex) and anesthetic solution characteristics (marginally hyperbaric) to prevent local anesthetic maldistribution.
Main Results:
- The study reviews the established continuous spinal anesthesia technique.
- Original data on CSA for peripheral vascular surgery is presented.
- Strategies for reducing local anesthetic maldistribution, such as precise catheter placement and use of marginally hyperbaric solutions, are discussed.
Conclusions:
- Continuous spinal anesthesia is a viable option for peripheral vascular surgery.
- Careful attention to catheter placement and anesthetic properties can potentially reduce the incidence of complications.
- Further research is warranted to fully elucidate the safety and efficacy of CSA in this surgical context.
Related Concept Videos
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
01:11Local 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...
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
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.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
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...
One of the advantages of...
01:24General Anesthesia: Overview
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:22Stages of General Anesthesia
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...