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Spinal anaesthesia 

Spinal anaesthesia
Chapter:
Spinal anaesthesia
Author(s):

Paul Clyburn

DOI:
10.1093/med/9780199572144.003.0007
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date: 12 December 2017

Where spinal anaesthesia can be safely performed, it is the method of choice for caesarean section in most situations

It should not be used when there is haemodynamic instability such as hypovolaemia from haemorrhage (obvious or concealed), or significant stenotic heart valve lesions

It should not be used in patients with bleeding disorders, including those on effective anticoagulant therapy

Strict asepsis should be used when performing spinal anaesthesia

Position the patient carefully (with good back flexion and avoid twisting of the spine) BEFORE scrubbing up to perform the block

Full equipment to undertake general anaesthesia should be available together with monitoring of pulse and blood pressure, resuscitation drugs and vasoconstrictor drugs to treat the hypotension that frequently occurs

Following spinal anaesthesia, the mother should be placed in a left tilted or pelvis wedged position to reduce the effects of aorto caval compression

Following surgery, the mother should be monitored in the same way as following a general anaesthetic.

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