Continuous Spinal Anesthesia with High Dose of Local Anesthetics

Imbelloni, Luiz Eduardo; Neto, Savino Gasparini; Ganem, Eliana Marisa

doi:10.1016/s0034-7094(10)70065-9

Cited by 4 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[51213] Clinical studies have shown that hemodynamic stability is greater with CSA than with other neuraxial anesthesia techniques,[123814] but limited studies have been published on this technique for elderly patients. Few studies or case reports[9101516] have evaluated the efficacy and safety of CSA in this population, probably because of concerns about potential adverse effects-principally neurologic complications and PDPH.…”

Section: Discussionmentioning

confidence: 99%

“…The Imbelloni et al . study[12] reported the possible safety of the new catheter with a large dose of hyperbaric 0.5% bupivacaine and hyperbaric 2% lidocaine in a physical status ASA III, citing a 78-year-old patient who underwent CSA for surgery for huge bilateral inguinal and umbilical hernias. In this case, the authors concluded that, with the administration of high doses of hyperbaric anesthetics through the new catheter, poor distribution or risk of Cauda Equina syndrome were not observed.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of unilateral spinal and continous spinal anesthesia for hip surgery in elderly patients

et al. 2013

View full text Add to dashboard Cite

Background:Continous spinal anesthesia (CSA) and frequently unilateral spinal anesthesia (USpA) are usually preferred for lower extremity surgeries. In this study, we aimed to compare the effects of these anesthetic techniques, on hemodynamic parameters, quality of anesthesia and complications in elderly patients undergoing hip surgeries.Methods:Forty patients aged 65 years and older, assigned to receive either CSA or USpA with 7.5 mg (1.5 cc) 0.5% hyperbaric bupivacaine initially. In CSA group, additional doses of 2.5 mg bupivacaine were applied until sensory block reach to T10. Maximum sensorial block level, time to reach the level of T10 (defined as onset time) and to regress to T12, hemodynamic parameters and ephedrine requirements were recorded peroperatively and during 2 h postoperatively.Results:Hemodynamic parameters, ephedrine requirements and regression of sensory block by two levels were similar in two groups. The onset time of anesthesia was significantly longer in USpA group than CSA group. Neuraxial anesthesia had to be converted to general anesthesia in 5 patients (25%) in CSA group and 1 patient (5%) in USpA group.Conclusions:We conclude that both USpA and CSA techniques have similar effects in elderly high risk patients. On the other hand, USpA is more preferable for surgeries with shorter durations due to its low cost and high success rate.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of unilateral spinal and continous spinal anesthesia for hip surgery in elderly patients

et al. 2013

View full text Add to dashboard Cite

show abstract

“…With the advent of intermediate catheters catheter through the needle, caliber 22G and 24G for continuous spinal anesthesia, and their low incidence of headache and neurological symptoms, the technique has been gaining credibility and is safe with high doses of bupivacaine 0.5% hyperbaric with 1.6% glucose 25 mg associated with hyperbaric 2% lidocaine with 1.6% glucose 160 mg, and morphine 100 µg, surgery lasting seven hours. 47 This case report suggests that neither lidocaine nor glucose contributes to cauda equina syndrome when used with intermediate catheters and doses within the normal range. With the use of the 27G needle and 22G catheter set, there was no maldistribution with any of the drugs, resulting in rapid recovery from a motor block and sensitivity, without transient or definitive neurological complications.…”

Section: Continuous Spinal Anesthesiamentioning

confidence: 77%

Old anatomy and new anatomical concepts for single shot and continuous spinal anesthesia

Imbelloni,

Gouveia,

Neto

et al. 2023

JACCOA

View full text Add to dashboard Cite

This educational article shows the anatomy studied in cadavers and the latest imaging technology for spinal anesthesia. Neuraxial anesthesia is one of the regional anesthetic options that can be done by blocking the spinal cord neural transmission through the administration of local anesthetics either via intrathecal, epidural, continuous spinal anesthesia, or combined epidural-spinal anesthesia. Several descriptions of the spinal canal anatomy have been reported since the 16th century by Leonardo da Vinci, and the use of modern radiological imaging technology has provided important insights into understanding anatomical and pathophysiological aspects implicated in spinal anesthesia. The vertebral level at which the spinal cord finishes varies widely from T12 to the L3-L4 intervertebral disc and the spinal cord extends to the L1-L2 and the L2-L3. In this educational study, cadaver anatomy and new approaches with ultrasound, magnetic resonance imaging, computed tomography, and fluoroscopy will be covered, to approach spinal and continuous spinal anesthesia. Between the medulla and any given level of the spinal cord, the fibers of the anterolateral system and posterior columns are dissociated. Despite all the new imaging studies to assist in performing subarachnoid punctures for single shot or continuous spinal anesthesia, anatomical landmarks remain the most used for both the lumbar and thoracic approaches.

show abstract

“…Three years after, it arrived in Brazil and one year after, the first article was published with this new catheter for CSA in 40 patients with orthopedic lower limb surgery [44]. In 2010, this catheter was used in a 78-year-old patient with massive bilateral inguinal and umbilical hernias, resulting in its safe use with large doses of 25 mg of 0.5% hyperbaric bupivacaine with 1.6% glucose associated with 160 mg of 2% hyperbaric lidocaine with 1.6% glucose, and 100 µg morphine [45].…”

Section: Continuous Spinal Anesthesia and Cauda Equina Syndromementioning

confidence: 99%

Cauda Equina Syndrome and Spinal and Epidural Anesthesia. The Influence of Local Anesthetic, Needle Type and Position of Puncture

Imbelloni

2023

J Sur Anesth Res

View full text Add to dashboard Cite

Background and Objectives: Severe complications such as Cauda Equina Syndrome (CES) lead to temporary or permanent disability have been ascribed to central neuraxial blocks. Some case reports, and very few retrospective studies, have focused their attention on the fact that central nerve blocks can cause, albeit rarely, permanent damage to the spinal cord or nerve roots, or both. This study is the experience of 48 years with spinal anesthesia and several publications and no definite neurological complications. This study is not a review of the subject. The primary objective of this study was to analyze the characteristics in relation to needles, puncture position, types of anesthetics, and baricity of local anesthetics.

show abstract

Continuous Spinal Anesthesia with High Dose of Local Anesthetics

Cited by 4 publications

References 24 publications

Comparison of unilateral spinal and continous spinal anesthesia for hip surgery in elderly patients

Comparison of unilateral spinal and continous spinal anesthesia for hip surgery in elderly patients

Old anatomy and new anatomical concepts for single shot and continuous spinal anesthesia

Cauda Equina Syndrome and Spinal and Epidural Anesthesia. The Influence of Local Anesthetic, Needle Type and Position of Puncture

Contact Info

Product

Resources

About