Spinal anesthesia

Description:

Spinal anesthesia — a type of local anesthesia at which anesthetic in the course of a lumbar puncture is entered into a subdural space and blocking of transfer of an impulse occurs at the level of roots of spinal nerves.
Contraindications to spinal anesthesia:

Absolute:

    * Refusal of the patient.
    * Lack of necessary conditions and equipment for full observation of a condition of the woman in labor during anesthesia and effective treatment of potentially possible complications.
    * Coagulopathies.
    * Anticoagulating therapy by indirect anticoagulants, low-molecular heparins in the last 12 hours.
    * A skin infection in the field of a puncture.
    * Intracranial hypertensia.
    * Lack of reserves for increase in cordial emission due to increase in heart rate and a stroke output (for example, full AV blockade, the expressed aortal stenosis). Sometimes in such cases it is possible to carry out the prolonged spinal anesthesia or the combined spinal and epidural anesthesia.

Relative:

    * Psychological and emotional lability of the woman in labor.
    * Mental and neurologic diseases, low I.Q. (oligophrenia, etc.)
    * Heart diseases with the fixed cordial emission (an idiopathic hypertrophic subaortal stenosis, an aortal stenosis, a mitral stenosis, etc.)
    * Unknown duration of an estimated operative measure and possibility of expansion of volume of operation (hysterectomy, supravaginal amputation, etc.)
    * Anatomic anomalies of a backbone.
    * Preventive purpose of low doses of heparin, treatment by dezagregant.
    * Existence of malformations of a fruit, antenatal death of a fruit.
    * The local displays of an infection localized on the periphery of the place of an estimated puncture.
    * The expressed hypovolemia and real risk of development of massive bleeding (placental detachment, a hysterorrhesis, hypotonic bleedings, etc.)
    * Distress fruit syndrome.
    * The expressed signs of a syndrome of an aorto-caval compression.
    * The expressed vagotonia signs, frequent syncopal states in the anamnesis, a sick sinus syndrome, AV blockade.
Spinal anesthesia is carried out in the same place, as epidural anesthesia, but with some differences:
• more fine needle is used,
• the anesthetic dose for the spinal block much less is also entered it lower than the level of a spinal cord into the space containing cerebrospinal fluid.

Right after an injection the feeling of numbness in the lower part of a trunk quickly develops in a subdural space of anesthetic.