Conclusions
It has been indicated that no other type of anaesthesia will provide so much for so little, and it is apparent that most of our fears of spinal anaesthesia are unfounded, being based upon the results obtained following its early indiscriminate use. A vast majority of the major complications have been due to the administration of toxic local anaesthetic agents, traumatic spinal needles, and inadequate and improper cleansing and sterilization of the equipment and the local anaesthetic agents used. It is also apparent that a great number of the complications which have been attributed to spinal anaesthesia in the past were actually due to other causes.
Spinal anaesthesia is now well known and well understood. Its limitations have been clearly defined and the indications for its use are generally accepted, as are the physiological principles underlying its application. The great number of uncomplicated spinal anaesthetics which have been recorded during the past decade attest to the relative safety of the local anaesthetic agents themselves. It is therefore suggested that most of the significant complications of spinal anaesthesia, with the probable exception of headache, are not only preventable but also of relatively rare ocurrence following modern techniques of administration.
Résumé
On a démontré qu’aucun autre genre d’anesthésie ne donne tant pour si peu et il apparaît que la plupart de nos craintes au sujet de l’anesthésie rachidienne sont sans fondement; ces craintes sont basées sur les résultats obtenus à la suite de l’usage prématuré et sans discernement de cette technique d’anesthésie.
Une grande majorité des complications graves ont été dûs à l’administration d’anesthésiques locaux toxiques, à des aiguilles traumatisante, à une défectuosité dans le nettoyage et la stérilisation du matériel et des anesthésiques locaux utilisés. Il est également évident qu’un grand nombre des complications attribuées dans le passé à l’anesthésie rachidienne étaient dues en réalité à d’autres causes.
Maintenant l’anesthésie rachidienne est bien connue et bien comprise. Ses limites ont été clairement définies, et ses indications sont généralement reconnues de même que les principes physiologiques sur lesquels repose son application. Le grand nombre de cas sans complications rapportés durant la dernière décade témoignent de la sûreté des agents eux-mêmes. On peut alors affirmer que la plupart des complications importantes de l’anesthésie rachidienne, à l’exception peut-être de la céphalée, sont non seulement évitables mais relativement rares à la suite des techniques modernes d’administration.
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Lund, P.C., Cwik, J.G. Modern trends in spinal anaesthesia. Can. Anaes. Soc. J. 15, 118–134 (1968). https://doi.org/10.1007/BF03005719
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DOI: https://doi.org/10.1007/BF03005719