Continuous Spinal Anesthesia for Obstetric Anesthesia and Analgesia

Abstract

The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used. Small doses of drug can be administered and extension of labor analgesia for emergency cesarean delivery may occur more rapidly compared to continuous epidural techniques.

Continuous Spinal Anaesthesia for Intertrochanteric Femur Fracture in a Patient with Skeletal Dysplasia

“…As a result, the block is well predicted and tends to cause less hemodynamic perturbations [11,12]. Hence, it forms the basis for usage of CSA in high-risk cases [11,13] and allows CSA to be still in the game and in par with SSA and CEA. CEA on the contrary provides a segmental neural blockade and requires high volumes of local anaesthetics (LA).…”

Accidental dural puncture-perioperative management

“…However, there are rare possible complications associated with intrathecal catheterisation including meningitis, epidural or spinal abscess, hematoma, arachnoiditis, or cauda equina syndrome. [ 11 ]…”

Effects on newborns of applying bupivacaine combined with different doses of fentanyl for cesarean section

“…Spinal anesthesia[ 3 , 4 ] is a common method of anesthesia for cesarean section. In fact, many studies have shown that opioids plus local anesthetics can have many benefits, such as prolonging the time of intraoperative and postoperative analgesia[ 5 ], effectively inhibiting the traction reaction caused by surgery[ 6 ] and allowing more stable hemodynamics[ 7 ].…”