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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.
An outgrowth of this committee, the Anesthesia Patient Safety Foundation was created in 1985 as an independent, nonprofit corporation with the vision that "no patient shall be harmed by anesthesia". [25] The current mortality attributable to the management of general anesthesia is controversial. [26]
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]
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.
However, the standard length of a spinal needle (90mm) may be insufficiently long to reach the subarachnoid space through the Tuohy needle. An extra-long needle (e.g., 120 mm) may be required. Alternatively, several manufacturers produce packs containing both a spinal and an epidural needle which are slightly modified to fit together.
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 ...
Full wakefulness and general anesthesia are the two extremes of the spectrum. Conscious sedation and monitored anesthesia care (MAC) refer to an awareness somewhere in the middle of the spectrum, depending on the degree to which a patient is sedated. Monitored anesthesia care involves titration of local anesthesia along with sedation and ...
The very long-term outcome (mean follow-up time of 12.4 years) was excellent-to-good in 68% of patients (59% women and 73% men). Furthermore, in the longitudinal follow-up, the result improved between 1985 and 1991. No special complications were manifested during this very long-term follow-up time.