Safety in Spinal Anesthesia from Asepsis and Antisepsis to Total Recovery from Block

Abstract

In the early 20th century, glucose was added to local anesthetics, making it the preferred choice of anesthesiologists worldwide. Before offering a patient spinal anesthesia, an anesthesiologist not only must be aware of the indications and contraindications of spinal anesthesia but also must be able to weigh the risks and benefits of performing the procedure. Asepsis and antisepsis of the back should be carried out with alcoholic chlorhexidine or 70% alcohol,allowing it to dry spontaneously. The MRI confirmed Jonnesco’s teachings on the safety of thoracic spinal anesthesia using puncture above T11. Likewise,when a lumbar puncture is performed, it should be performed below L3, preferably as low as possible. Subarachnoid puncture should be performed with a needle of the smallest gauge and tip preferred by the anesthesiologist. If using an introducer, make a puncture in the skin to avoid introducing skin tissue. For safety, use isobaric, hyperbaric and hypobaric solutions. Adjuvants should be injected into separate syringes, as they alter the baricity of local anesthetics. Always remember that the spinal cord was placed inside a bony tube to avoid the injection of any drugs. This educational article shows some ways to perform single shot spinal anesthesia safely for patients.