Physiology of Spinal Anesthesia

This monograph aims to examine in detail the causes and effects of physiologic changes produced by the subarachnoid injection of local anaesthetics.

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The purpose of this monograph is to examine in detail the causes and effects of physiologic changes produced by the subarachnoid injection of local anaesthetics. Techniques of spinal anaesthesia, that is how and where to inject the local anaesthetic and the clinical indications and contra-indications to do so, are not considered. Pharmacologic aspects of spinal anaesthesia are considered only insofar as they relate to physiologic responses. Mode of action of local anaesthetics, a pharmacologic, not physiologic topic, is not reviewed in depth. Factors that govern distribution of local anaesthetics within cerebrospinal fluid and, thus, sensory levels of anaesthesia, involve complexities beyond the scope of this monograph. Because of the well deserved popularity of epidural anaesthesia and because there are indeed several noteworthy similarities with spinal anaesthesia, a chapter on epidural anaesthesia is included that briefly compares physiologic responses to epidural anaesthesia, related but quite different techniques. The subject of this monograph is spinal anaesthesia, with the emphasis on anaesthesia.