الفهرس | Only 14 pages are availabe for public view |
Abstract Continuous spinal anesthesia (CSA) is the technique of producing and maintaining spinal anesthesia with small doses of local anesthetic which are injected intermittently into the subarachnoid space via an indwelling catheter. It is considered a longstanding anesthetic technique that could be used for surgery of the lower limbs and lower abdomen. It is an underutilized technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia as single-dose spinal anesthesia and continuous epidural anesthesia, it has shown several advantages such as administration of local anesthetics in small incremental doses titrated to the individual patient’s needs, reduced requirements of local anesthetics and thus decreased systemic toxic effects, ensured cardiovascular stability, and extended anesthesia by supplemental application of spinal local analgesics when surgery is unexpectedly extended. CSE is currently popular and it is used in a wide variety of clinical settings, including general surgery, vascular surgery, urology, orthopedic surgery, obstetrics and gynecology and pediatric surgery. CSE seems to be particularly useful in ambulatory surgery, because it facilitates early patient ambulation and discharge to home. In addition, CSE probably has a role in patients with significant comorbidities, who need to undergo surgery and are considered at high risk for general anesthesia. |