Cintinuous Spinal Anesthesia

The continuous spinal anesthesia is an old technique, but recentdevelopment of fine bore catheters and fine needles has re-awakenedthe interest in the use of this technique. The fine bore needles are usedfor high risk groups to decrease the incidence of postdural punctureheadache, while the larger ones are used for old patients at lower risk.The technique is particularly useful for long operations of thelower limbs, specially vascular and orthopedic surgery, an advantage ofthe technique is the ability to tailor the duration of anesthesia to thelength of operation. After spinal anesthesia is achieved. repeated dosesare adminsitered when the patient notes any discomfort in the area ofthe incision and this ensures that local anesthetic will not accumulateand that anesthesia will recede quickly after the operation.The advantage over single-dose spinal anesthesia is that repeatedinjection of small doses of local anesthetic solution helps to obtain theexactly right level of anesthesia, minimizes cardiovascular instabilityand shortens the recovery period. Also through the catheter,subarachnoid narcotics may be administered for long-lastingpostoperative analgesia.Disadvantages and complications of continuous spinal anesthesiainclude those related to catheter, neurologic, infectious complicationsand others that include hypotension, backache, subdural injection,intravascular injection and inadequate anesthesia.