[Spinal anesthesia: a step backward or a step forward?].

The authors analyze the evolution of methods of segmentary blocking over 100 years of their application. They compare the potentialities of and indications for epidural and spinal anesthesia. Variants of spinal anesthesia based on high technologies (making use of fine atraumatic needles for spinal anesthesia, microcatheter technique of prolonged spinal anesthesia, and combined technique of spinal epidural anesthesia) and the pharmacology of new local anesthetics used for both spinal and epidural segmentary blocking are characterized. The authors analyze the surgical pathophysiology of a segmentary conduction block and compare the efficacy of protection from operation stress under total and segmentary anesthesia and the structure and incidence of intra- and postoperative complications. They validate the perspectives of spinal anesthesia methods which can be widely used in practical anesthesiology.