PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 8760645

[Sequential anesthesia-analgesia].

J Brassier
View original source ↗Export metadata ↓

Abstract

Combined spinal-epidural anaesthesia (CSEA) is realized by one route immediately before the surgical procedure. It consists of: -a spinal anaesthesia for the operation itself. -followed by the installation of a catheter in the epidural space, so as to ensure postoperative analgesia. CSEA is a simple and attractive technique which requires only a good knowledge of its two components by the anaesthetist and the use of appropriate needles. Main indications are low abdomen surgery and major procedures on the lower limb. Real contra-indications are few. Updated recent needles could certainly extend the field and general use of this technique.

Explore related subjects

Anesthesia, EpiduralAnesthesia, SpinalAnesthetics, LocalHumansIntraoperative PeriodNeedlesPostoperative PainEnglish AbstractJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

J Brassier. 1996. [Sequential anesthesia-analgesia].. https://pubmed.ncbi.nlm.nih.gov/8760645/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed1999

Paraplegia after thoracotomy--not caused by the epidural catheter.

BACKGROUND: Paraplegia and peripheral nerve injuries may arise after general anaesthesia from many causes but are easily ascribed to central block if the latter has been used. CASE REPORT: A 56-yr-old woman, with Bechterev disease but otherwise healthy, was operated with left-sided thoracotomy to remove a tumour in the left lower lobe. She had an epidural catheter inserted in the mid-thoracic area before general anaesthesia was started. Bupivacaine 0.5% 5 ml was injected once and the infusion of bupivacaine 0.1% with 2 micrograms/ml fentanyl and 2 micrograms/ml adrenaline (5 ml/h) started at the end of surgery. The patient woke up with total paralysis in the lower limb and sensory analgesia at the level of T8, which remained unchanged at several observations. Laminectomy, performed 17 h after the primary operation, showed a large piece of a haemostatic sponge (Surgicel) compressing the spinal cord, which was then decompressed but the motor and sensory deficit remained virtually unchanged both then and a year later. CONCLUSIONS: This case shows--once again--that although central blocks may cause serious neurological complications and paraplegia, other causes are possible and have to be considered. However, all patients with an epidural catheter must be monitored for early signs and symptoms of an intraspinal process and the appropriate treatment has to be instituted instantly.

Anesthesia, Epidural↗