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- W1999601102 abstract "I suspect that I am not alone in using different techniques of combined spinal–epidural depending on the circumstances. I am becoming increasingly uneasy, however, about methods that involve inserting a spinal needle first, administering the dose, and then inserting the Tuohy needle. The ongoing debate about the advisability of attempting central neural blockade in anaesthetised, paralysed patients assumes that the anaesthesia is general anaesthesia. However, the profound block produced by a spinal dose of local anaesthetic such as that used for Caesarean section or even late labour will render the patient, though awake, into an anaesthetised paralysed state within seconds of the injection. Although the ‘difficult back’ of a distressed labouring woman seems to ‘cry out’ for a quick spinal to give immediate relief and make insertion of the Tuohy needle easier, we should be aware that we have obtunded that reaction which might protect the patient (and the anaesthetist) from subsequent nerve injury." @default.
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- W1999601102 date "2000-01-01" @default.
- W1999601102 modified "2023-09-24" @default.
- W1999601102 title "Combined spinal-epidural techniques and the awake/asleep debate" @default.
- W1999601102 doi "https://doi.org/10.1046/j.1365-2044.2000.01246.x" @default.
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