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Spinal anaesthesia
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Spinal anaesthesia : ウィキペディア英語版
Spinal anaesthesia

Spinal anaesthesia (or spinal anesthesia), also called spinal analgesia, spinal block or subarachnoid block (SAB), is a form of regional anaesthesia involving injection of a local anaesthetic into the subarachnoid space, generally through a fine needle, usually 9 cm long (3.5 inches). For extremely obese patients longer needles are available (12.7 cm / 5 inches). The tip of the spinal needle has a point or small bevel. Recently, pencil point needles have been made available (Whitacre, Sprotte, Gertie Marx & others).
==Medical uses==
Spinal anaesthesia is a commonly used anaesthetic technique, both alone and in combination with either sedation or general anaesthesia. Examples of uses include :-
* Orthopaedic surgery on the pelvis, femur, tibia and the ankle
* Hip replacement
* Knee replacement
* Hip fracture surgery
* Spinal opioids e.g. Diamorphine 500-1000mcg along with general anaesthesia for post operative analgesia in laparoscopic bowel surgery
* Lower limb vascular surgery
* Endovascular aortic aneurysm repair
* Hernia (inguinal or epigastric)
* Haemorrhoidectomy (Piles), fistulae and fissures
* Nephrectomy and Cystectomy in combination with general anaesthesia
* Transurethral resection of the prostate and transurethral resection of bladder tumours
* Abdominal and vaginal hysterectomies
* Laparoscopy assisted vaginal hysterectomies combined with general anaesthesia
* Caesarean sections
Spinal anaesthesia is the technique of choice for Caesarean section as it avoids a general anaesthetic and the risk of failed intubation (which is approximately 1 in 250 in pregnant women). It also means the mother is conscious and the partner is able to be present at the birth of the child. The post operative analgesia from intrathecal opioids in addition to non-steroidal anti-inflammatory drugs is also good.
If surgery allows, spinal anaesthesia is very useful in patients with severe respiratory disease e.g. COPD as it avoids intubation and ventilation. It may also be useful in patients where anatomical abnormalities may make tracheal intubation very difficult.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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