Volk Thomas
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2010 Mar;45(3):188-95. doi: 10.1055/s-0030-1249402. Epub 2010 Mar 15.
Spinal anesthesia is a safe procedure. The knowledge of complications may support efforts to minimize risks, speed up the recognition process and lead to adequate timely therapeutic approaches. Pain during insertion of the needle can be a warning signal for potential conus damage. Hypotension caused by spinal anesthesia should be treated by appropriate vasoactive drugs. Timely recognized cardiac arrest situations are usually well treatable. The incidence of postdural puncture headache should be less than 2% of cases. In case of a high degree of suffering the best currently available treatment is the epidural blood patch. Further complications like intracranial bleeding, infection, cauda equina syndrome or spinal hematoma need immediate differential diagnosis and therapeutic approaches. The residual risk for permanent harm can be estimated to be around 0,02 per thousand.
脊髓麻醉是一种安全的操作。了解并发症有助于努力将风险降至最低、加快识别过程并采取适当的及时治疗方法。穿刺针插入时的疼痛可能是圆锥潜在损伤的警示信号。脊髓麻醉引起的低血压应使用适当的血管活性药物治疗。及时识别的心脏骤停情况通常易于治疗。硬膜穿刺后头痛的发生率应低于病例的2%。在痛苦程度较高的情况下，目前最佳的治疗方法是硬膜外血贴。其他并发症，如颅内出血、感染、马尾综合征或脊髓血肿，需要立即进行鉴别诊断和治疗。永久性伤害的残余风险估计约为千分之0.02。
