[Subarachnoidal anesthesia: the limits of its potentials].
A total of 250 subarachnoidal anesthesias (SA) have been performed in patients operated on the lower limbs, perineum, external genitals, pelvic organs, and anterior abdominal wall at department for plastic and reconstructive surgery. The efficacy and safety of SA in everyday practice has been evaluated. A total of simultaneous 228 SA with three hyperbaric solutions were carried out: 5% ultracaine, 0.75% bupivacaine, 0.5% marcaine, and one isobaric solution 0.5% bupivacaine. Prolonged SA was administered to 10 patients and combined spinal-epidural anesthesia (CSEA) to 19. The sensory block was assessed by the pin prick test and the motor blocking by Bromage score. Of the central segmentary blockades, SA has been preferred for the above-listed interventions in recent years. Hyperbaric and isobaric solutions caused analgesia of different duration, latent period, and dissemination of the anesthetic under different clinical situations. Prolonged SA is justified in patients with limited hemodynamic reserves, and CSEA should be preferred when the expected duration of the intervention is longer than the estimated duration of SA effects. SA is an effective and safe method for surgical anesthesia on condition of proper choice of the local anesthetic, use of high-quality kits, and strict adherence to the protocol of subarachnoidal puncture and injection.
Svetlov
V A
VA
Kozlov
S P
SP
Vashchinskaia
T V
TV
Sarkisova
N G
NG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D013129:Spinal Puncture / Q000379:methods; D013346:Subarachnoid Space; D013997:Time Factors
D000779:Anesthetics, Local