Artikel ; Online: Failed spinal anaesthesia: mechanisms, management, and prevention.
British journal of anaesthesia
2009 Band 102, Heft 6, Seite(n) 739–748
Abstract: Although spinal (subarachnoid or intrathecal) anaesthesia is generally regarded as one of the most reliable types of regional block methods, the possibility of failure has long been recognized. Dealing with a spinal anaesthetic which is in some way ... ...
Abstract | Although spinal (subarachnoid or intrathecal) anaesthesia is generally regarded as one of the most reliable types of regional block methods, the possibility of failure has long been recognized. Dealing with a spinal anaesthetic which is in some way inadequate can be very difficult; so, the technique must be performed in a way which minimizes the risk of regional block. Thus, practitioners must be aware of all the possible mechanisms of failure so that, where possible, these mechanisms can be avoided. This review has considered the mechanisms in a sequential way: problems with lumbar puncture; errors in the preparation and injection of solutions; inadequate spreading of drugs through cerebrospinal fluid; failure of drug action on nervous tissue; and difficulties more related to patient management than the actual block. Techniques for minimizing the possibility of failure are discussed, all of them requiring, in essence, close attention to detail. Options for managing an inadequate block include repeating the injection, manipulation of the patient's posture to encourage wider spread of the injected solution, supplementation with local anaesthetic infiltration by the surgeon, use of systemic sedation or analgesic drugs, and recourse to general anaesthesia. Follow-up procedures must include full documentation of what happened, the provision of an explanation to the patient and, if indicated by events, detailed investigation. |
---|---|
Mesh-Begriff(e) | Anesthesia, Spinal/adverse effects ; Anesthesia, Spinal/methods ; Anesthetics, Local/administration & dosage ; Humans ; Medical Errors/prevention & control ; Spinal Puncture/adverse effects ; Treatment Failure |
Chemische Substanzen | Anesthetics, Local |
Sprache | Englisch |
Erscheinungsdatum | 2009-06 |
Erscheinungsland | England |
Dokumenttyp | Journal Article ; Review |
ZDB-ID | 80074-0 |
ISSN | 1471-6771 ; 0007-0912 |
ISSN (online) | 1471-6771 |
ISSN | 0007-0912 |
DOI | 10.1093/bja/aep096 |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
Zusatzmaterialien
Kategorien
Verfügbar in ZB MED Köln/Königswinter
Uk I Zs.80: Hefte anzeigen | Standort: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
Über subito bestellen
Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.