Anaesthesia for chronic spinal cord lesions

Hippokratia 2006, 10(1):28-31

Z Kanonidou
3rd Dpt Anaesthesiology, Hippokratio General Hospital, Thessaloniki, Greece


Abstract

Increasing numbers of patients with spinal cord injury present for surgery care. The most important perioperative risks are autonomic dysreflexia, bradycardia, hypotension, respiratory deficiency and muscle spasms. Patients with low, complete lesions, undergoing surgery below the level of injury, may safely do so without anaesthesia. An anaesthesiologist should be present to monitor the patient in this condition. General anaesthesia of sufficient depth is effective at controlling spasms and autonomic dysreflexia but hypotension and respiratory dysfunction are poten-tial risks. There is a growing consensus that techniques of regional anaesthesia are safe, effective and technically simple to perform in these patients.