Continuous Spinal Anesthesia and Analgesia in Obstetrics

Palmer, Craig M.

doi:10.1213/ane.0b013e3181f7e3f4

Cited by 59 publications

(25 citation statements)

References 20 publications

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“…This is consistent with the study institution's previously published success rate of 84% [2]. Although this success rate is lower than rates previously reported in adult obstetric literature [9,10], it is theorized this is likely related to the study's patient population. In this study, the majority of conversions to GA were related to failure of spinal needle placement.…”

Section: Discussionsupporting

confidence: 90%

Benefits of spinal anesthesia for urologic surgery in the youngest of patients

Ebert

Jayanthi

Alpert

et al. 2019

Journal of Pediatric Urology

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Section: Discussionsupporting

confidence: 90%

Benefits of spinal anesthesia for urologic surgery in the youngest of patients

Ebert

Jayanthi

Alpert

et al. 2019

Journal of Pediatric Urology

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“…CSA provides a number of potential advantages over other forms of anesthesia,1–3 including hemodynamic stability and extended analgesia 20,23,24. But some anesthesiologists are not permitted to use microcatheters, due to government concern over the risk of cauda equina syndrome, and others have remained reluctant to perform CSA, even with microcatheters, because of uncertainty about the incidence of PDPH.…”

Section: Discussionmentioning

confidence: 99%

“…Döhler et al18 observed no cases of PDPH in 154 patients, aged over 70 years (mean 82.3 years). Importantly, obstetric patients are at higher risk of PDPH than the general population, probably due to the younger age of the patients 21,23,24…”

Section: Discussionmentioning

confidence: 99%

Continuous spinal anesthesia for lower limb surgery: a retrospective analysis of 1212 cases

Lux¹

2012

LRA

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BackgroundContinuous spinal anesthesia is a very reliable and versatile technique for providing effective anesthesia and analgesia. However, the incidence of possible complications, including postdural puncture headache or neurological impairment, remains controversial. Therefore, the aim of the present retrospective study was to analyze a large number of patients for the incidence of adverse events after continuous spinal anesthesia with a microcatheter.MethodsThis retrospective study was conducted on 1212 patients who underwent surgery of the lower extremities with continuous spinal anesthesia, which was administered with 22-gauge Quincke spinal needles and 28-gauge microcatheters. Sociodemographic and clinical data were available from the patient records, and data on headaches and patient satisfaction were drawn from a brief postoperative patient questionnaire.ResultsThe patient population included 825 females (68%) and 387 males; the median age was 61 (56–76). The types of operations performed were 843 hip prostheses, 264 knee prostheses, and 105 other leg operations. No major complications were observed in any of these patients. Tension headaches were experienced by 190 (15.7%) patients, but postdural puncture headaches were reported by only 18 (1.5%) patients. Nearly all patients (98.4%) were satisfied with continuous spinal anesthesia and confirmed that they would choose this kind of anesthesia again.ConclusionBased on the findings of this large data analysis, continuous spinal anesthesia using a 28-gauge microcatheter appears to be a safe and appropriate anesthetic technique in lower leg surgery for aged patients.

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“…Sometimes scar tissue prevents adequate spread of local anaesthesia in the epidural space. In this instance continuous spinal anaesthesia (CSA) may be considered after senior anaesthetic review …”

Section: Pregnancy After Spinal Cord Injurymentioning

confidence: 99%

Pregnancy and spinal cord injury

Dawood

Altanis

Ribes-Pastor

et al. 2014

The Obstetric & Gynaecologis

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Key content Pregnancy exacerbates most problems associated with spinal cord injury (SCI). Diagnosis of labour in women with spinal cord injury above T10 of the spinal cord can be challenging. Women with SCI should aim for a vaginal delivery. Autonomic dysreflexia is life threatening and requires immediate treatment. Early epidural analgesia in labour will reduce the incidence of autonomic dysreflexia. Learning objectives Antenatal management of women with SCI. Care of a woman in labour. Diagnosis and treatment of autonomic dysreflexia. Ethical issues Women with chronic SCI are knowledgeable about the management of their disability, at times more than the attending medical personnel. Not listening to them may undermine the confidence they have in their care. Women with SCI are concerned that a spinal or epidural analgesia may cause further injury to their spinal cord.

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Continuous Spinal Anesthesia and Analgesia in Obstetrics

Cited by 59 publications

References 20 publications

Benefits of spinal anesthesia for urologic surgery in the youngest of patients

Benefits of spinal anesthesia for urologic surgery in the youngest of patients

Continuous spinal anesthesia for lower limb surgery: a retrospective analysis of 1212 cases

Pregnancy and spinal cord injury

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