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Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, [1] is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long.
Postanesthetic shivering is one of the leading causes of discomfort in patients recovering from general anesthesia. It usually results due to the anesthetic inhibiting the body's thermoregulatory capability, although cutaneous vasodilation (triggered by post-operative pain) may also be a causative factor.
Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord). [3] The headache is severe and described as "searing and spreading like hot metal", involving the back and front of the head and spreading to the neck and shoulders, sometimes involving neck stiffness.
Multiple studies have demonstrated that incomplete reversal of NMBDs is an important risk factor for postoperative morbidity and mortality. Multiple studies have shown that postoperative residual curarization in the post-anesthesia care unit (PACU) is a common complication, with 40% of patients exhibiting signs of residual paralysis.
Anesthetic risk factors include the use of volatile anesthetics, nitrous oxide (N 2 O), opioids, and longer duration of anesthesia. Patient factors that confer increased risk for PONV include female gender, obesity , age less than 16 years, past history of motion sickness or chemotherapy-induced nausea, high levels of preoperative anxiety , and ...
Age, duration of anaesthesia, introperative complications, and postoperative infections were found to be associated with POCD. [3] POCD is just as likely to occur after operations under regional anesthesia as under general anesthesia. [2] [4] More likely after major operations than minor operations. [9] [11]
In adults, the spinal cord terminates around the level of the disc between L1 and L2, while in neonates it extends to L3 but can reach as low as L4. [16] Below the spinal cord there is a bundle of nerves known as the cauda equina or "horse's tail". Hence, lumbar epidural injections carry a low risk of injuring the spinal cord.
It was modified and revived in the 1990s, primarily by chiropractors, and also by osteopathic physicians; this was likely due to safer anesthesia used for conscious sedation, along with increased interest in spinal manipulation (SM). [26] In the MUA literature, spinal manipulation under anesthesia has been described as a controversial procedure.