| Physiology of Total Spinal Anesthesia . |
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Jae Kyu Jeon, Jung In Bae |
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Department of Anesthesiology, Keimyung University School of Medicine, Taegu, Korea. |
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| Abstract |
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Total spinal anesthesia is a serious life threatening complication of spinaI and epidural anesthesia and paravertebral block etc. We had 2 cases of accidental total spinal anesthesia associated with cranial nerve paralysis and eventual unconsciousness. Thereafter we have attempted to observe the clear physiologic changes resulting from total spinal anesthesia. Deliberate total spinal anesthesia was induced in 11 elective cases(Table I) for various proposed surgeries such as tonsillectomy, mastectomy and a variety of abdominal operations. Lumbar tapping for total spinal anesthesia was performed in a sitting position at a level between L 2-5, using a 22 gauze Whitacre pencil point needle, then 300 to 750 mg of 2% or 5% lidocaine solution was injected into the subarachnoid space, followed by the patient lying down in a steep Trandelenburg position.
Shortly after the spinal injection of lidocaine, many physiologic ehangea from total spinal anesthesia could be clearly observed. We have described the results of our observation as well as the general physiology of spinal anesthesia according to the following classification, the nervous system, csrdiovascular system, gastrointestinal system, genitourinary system, levels of seeing, hearing and consciousness. Note that this study was done according to the studies which Koster, HK had performed on 3500 cases in 1928. |
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