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Combined Spinal-Epidural Anesthesia? (15184 words) |
 | Spinal block is a simple technique which requires a small dose of local anesthetic to provide surgical anesthesia (1,2) with rapid, intense and reliable block without missed segments (1,3), greater muscle relaxation (1) and minimal risk of drug toxicity to the mother as well as to the fetus (3). |
| The incidence of spinal anesthesia in an orthopedic institute in Firenze increased from 22% in 1989 to 42% in 1993 (6). |
| Spinal anesthesia patients were quicker to drink fluids (3.4±0.3 vs. 5.1 ±0.7 hr), required less narcotic analgesia (0.6 ±1 vs. 1.2±0.2 intramuscular injections) and had a lower incidence of vomiting (0.2±0.09 vs. 1.07±0.34). |
| Spinal Anaesthesia and Specific CV Conditions (1191 words) |
| Spinal anaesthesia is not contraindicated in patients with coronary artery disease. |
| Spinal anaesthesia presents difficulties in women with mitral stenosis and the onset of a tachycardia may result in cardiac decompensation and pulmonary oedema. |
| Although the benefits of spinal anaesthesia over general anaesthesia with respect to cardiac morbidity reduction remain unproven, there is no reason to believe that morbidity is increased provided that there is a clear understanding of the haemodynamic effects and of the requirement for appropriate and timely intervention. |
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