title: [Crisis management during regional anesthesia including peripheral nerve block, epidural anesthesia and spinal anesthesia].
abstract: Crisis management during regional anesthesia including peripheral nerve block, epidural anesthesia and spinal anesthesia was reviewed. Common crisis which is encountered during regional anesthesia includes toxic reaction to local anesthetic drugs, allergic reaction induced by local anesthetic drugs, reaction induced by epinephrine, nerve injury, hematoma etc. Concerning peripheral nerve block, crisis encountered during brachial plexus block, interscalene block and supraclavicular block used for surgical operation of upper extremity was discussed. On the other hands, there are various common crises encountered during epidural anesthesia and spinal anesthesia. These crises include hypotension, bradycardia, total spinal anesthesia, postspinal headache and infection, and hematoma in the spinal canal. Especially, epidural hematoma and epidural abcess have possibility to cause nerve defect symptoms such as motor paralysis and sensory disturbance if appropriate treatment was not started in early stage. Moreover crisis such as cauda equina syndrome and anterior spinal cord syndrome have possibility to remain permanent and hard to cure. We anesthesiologists should make efforts to prevent crisis, to detect crisis in early stage, and to treat it in early stage.
authors.affiliation: Department of Anesthesiology, Nihon University School of Medicine, Surugadai Nihon University Hospital, Tokyo 101-8309.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saeki
authors.forename: Makiko
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Eri
authors.initials: E
authors.lastname: Miyake
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D000777:Anesthetics / Q000506:poisoning; D003975:Diazepam / Q000008:administration & dosage; D004342:Drug Hypersensitivity / Q000517:prevention & control / Q000628:therapy; D004809:Ephedrine / Q000008:administration & dosage; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D006336:Heart Massage; D006801:Humans; D007262:Infusions, Intravenous; D007431:Intraoperative Complications / Q000517:prevention & control* / Q000628:therapy*; D009407:Nerve Block / Q000009:adverse effects; D010525:Peripheral Nerves; D012121:Respiration, Artificial; D012308:Risk Management
chemical_list: D000777:Anesthetics; D005217:Fat Emulsions, Intravenous; D004809:Ephedrine; D003975:Diazepam