Total spinal anesthesia

Total spinal anesthesia is the most serious complication of epidural anesthesia, which is mainly due to the fact that the puncture needle strays into the subarachnoid space during epidural puncture and is not detected. Because the amount of local anesthetic required for epidural block is much larger than that for subarachnoid anesthesia, the total spinal anesthesia is caused by the injection of too much local anesthetic into the subarachnoid space. Within minutes, the patient may experience respiratory arrest, drop in blood pressure, or even loss of consciousness, which can lead to cardiac arrest if not detected or managed properly. Total spinal anesthesia is the most serious complication of epidural anesthesia. Once total spinal anesthesia occurs, artificial respiration should be performed immediately, rapid infusion of fluids and intravenously injected vasoconstrictor to maintain normal blood pressure. In case of cardiac arrest, cardiopulmonary resuscitation should be performed immediately. Preventive measures include withdrawal before epidural catheterization and infusion after cerebrospinal fluid reflux; The experimental dose of 3 ~ 5ml was given first and observed for 5 ~ 10 minutes. If no local anesthetic was mistakenly injected into the subarachnoid space, the injection was continued.