Subarachnoid Spinal Analgesia. Changing Patterns of Practice

Abstract

The results of a postal enquiry into the current usage of subarachnoid spinal analgesia in Scotland are compared with those obtained in 1976. On each occasion replies were received from more than 70% of those consultants receiving questionnaires. Replies indicating use of the techniques increased from 40% in 1976 to 75% in 1981 and this was accompanied by an increase in the frequency of usage and a decline in medico-legal anxiety. While medical conditions retain their importance, the use of surgical procedures as primary indications has increased. The majority of consultants currently practising extradural techniques also use spinal methods, and there have been changes in attitude regarding the place and safety of both. There is continued minority dissatisfaction with the choice of spinal agents. No major neurological sequelae were reported and replies indicating that subarachnoid spinal analgesia had a useful place in practice increased from 80% in 1976 to more than 90% in 1981. RESULTS Results of 1981 surveyReplies were received from 169 consultants (74.8%) and 126 (74.6%) stated that they currently used subarachnoid spinal analgesia. No practical

Intrazerebrale Massenblutung und Arteria-spinalis-anterior-Syndrom in ursächlichem Zusammenhang mit rückenmarksnahen Betäubungsverfahren? - Zwei Fallbeschreibungen

“…Eine spezifische neurologische Komplikation war jedoch nicht angesprochen worden. Das Ausbleiben neurologischer Folgen wurde anläßlich einer Umfrage unter Anästhesisten besonders hervorgehoben als Grund für die zunehmende Wiederverwendung der Spinalanästhesie (13). Gewiß ist Usubiaga beizupflichten, daß die Prophylaxe neurologischer Komplikationen das Ziel bleibe und daß dies am besten zu erreichen sei nicht nur durch gute Technik und adäquates Monitoring, sondern auch durch sorgfältige Auswahl der Patienten (17).…”