Anatomy and pathophysiology of spinal cord injury associated with neuraxial anesthesia

O.A. Loskutov, A.M. Strokan, O.M. Mykhalchenko, V.V. Martsyniv

Abstract


The article deals with the issue of anatomical and physiological injuries of the central nervous structures during neuraxial anesthesia and pain medicine procedures. This article also considers the pathophysiology of spinal cord injury related to mechanical trauma from direct needle/catheter injury or mass lesions, spinal cord ischemia or vascular injury from direct needle/catheter trauma, and neurotoxicity from local anesthetics, adjuvants or antiseptics. It describes the significance of spinal stenosis occurrence in patient, blood pressure control during neuraxial blockade, neuraxial injury subsequent to transforaminal procedures, cauda equina syndrome/local anesthetic neurotoxicity/arachnoiditis, and regional anesthesia or pain medicine procedures in patients concomitantly receiving general anesthesia or deep sedation. There were provided various techniques of radiological examination for high risk-group patients, who underwent neuraxial anesthesia and received medical treatment in “Feofaniya” Clinical Hospital. Also, some recommendations were given concerning reduction of the incidence of spinal cord injury related to neuraxial anesthesia and pain medicine techniques.

Keywords


neuraxial anesthesia; spinal cord; complications; spinal stenosis; pain medicine procedures

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DOI: https://doi.org/10.22141/2224-0586.4.83.2017.107427

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