Understanding Anesthesiology - The Global Regional Anesthesia ...

Table 11 Contraindications to central neural blockade
GENERAL
lack of consent
SPECIFIC
(ABSOLUTE)
coagulopathy
SPECIFIC
(RELATIVE)
evolving
neurological
deficit
Spinal Anesthesia
Spinal anesthesia involves the blockade of the nerves
of the spinal cord and cauda equina by injection of LA
into the intrathecal space. The important anatomy is
depicted in Figure 15 and Figure 16. Because the LA is
injected in close proximity to its site of action, much
smaller volumes are required (1-3 ml) and the onset of
effect (within 5 minutes) is rapid relative to epidural an-
Figure 15 Needle placement in spinal anesthesia
lack of
resuscitative
equipment
known or
suspected
allergy
sepsis (systemic
or at site of
injection)
increased
intracranial
pressure (ICP)
obstructive
cardiac lesion
(e.g. aortic
stenosis)
spinal hardware
lack of
familiarity with
technique
shock
known or
suspected
allergy
From “Introduction to Regional Anaesthesia” by D.
Bruce Scott (1989). Used with permission from his
wife, Joan and son, Nicholas B. Scott.
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