Chapter

Spinal anaesthesia

Paul Clyburn

in Obstetric Anaesthesia for Developing Countries

Published on behalf of Oxford University Press

ISBN: 9780199572144
Published online May 2011 | e-ISBN: 9780199607488 | DOI: http://dx.doi.org/10.1093/med/9780199572144.003.0007

Series: Oxford Anaesthesia Library

Spinal anaesthesia

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• Where spinal anaesthesia can be safely performed, it is the method of choice for caesarean section in most situations • It should not be used when there is haemodynamic instability such as hypovolaemia from haemorrhage (obvious or concealed), or significant stenotic heart valve lesions • It should not be used in patients with bleeding disorders, including those on effective anticoagulant therapy • Strict asepsis should be used when performing spinal anaesthesia • Position the patient carefully (with good back flexion and avoid twisting of the spine) BEFORE scrubbing up to perform the block • Full equipment to undertake general anaesthesia should be available together with monitoring of pulse and blood pressure, resuscitation drugs and vasoconstrictor drugs to treat the hypotension that frequently occurs • Following spinal anaesthesia, the mother should be placed in a left tilted or pelvis wedged position to reduce the effects of aorto caval compression • Following surgery, the mother should be monitored in the same way as following a general anaesthetic.

Chapter.  3857 words.  Illustrated.

Subjects: Anaesthetics

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