Spinal anesthesia and its neurological complications. A literature review article.
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Abstract
Introduction: Spinal cord injury may occur, during anesthetic practice and is a rare event, but may reach increased morbidity and mortality, The main neurological complications of spinal anesthesia are: Dural postunction headache and neurological damage. Objective: to review the literature on spinal anesthesia and its neurological complications. Materials and Methods: A retrospective descriptive study was carried out, with an advanced search for 27 articles, mostly since 2017, which include: systematic reviews, articles presenting clinical cases, investigations on spinal anesthesia and its neurological complications, consulting databases of high academic and research recognition, such as Pubmed, Elsevier, BMJ Journals, World Health Organization-World Federation of Societies of Anesthesiologists, epistemonikos, springer, among others.
Discussion: According to meta-analyses and studies consulted, lidocaine is the local anesthetic that has the greatest association with neurological complication of the transient neurological syndrome type, however, cases of a lower percentage with other anesthetics have also been described. The position in lateral decubitus during the anesthesia technique has a great influence, as a measure of prevention of post-puncture headache, which occurs in some patients as a complication of spinal anesthesia. There are multiple factors that contribute to the development of a neurological complication such as genetic factors, the age of the patient, abnormalities in the vertebral canal, obesity, diabetes, and others. Conclusion: The most frequent neurological complications of spinal anesthesia are post-puncture headache and transient neurological syndrome, therefore, every anesthesiologist must be aware of the possibility of developing them and take the necessary preventive measures, especially in patients in whom puncture is difficult, adapting appropriate anaesthetic techniques and drugs, improving the quality of the anesthesia administered.
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