Review article

Spinal anesthesia for hip surgery – particularities

Marina Barković ; Clinic for Orthopaedic Surgery Lovran, Faculty of Medicine University of Rijeka, Rijeka, Croatia
Aleksandra Šurdonja-Bobinac ; Clinic for Orthopaedic Surgery Lovran, Faculty of Medicine University of Rijeka, Rijeka, Croatia
Katarina Šakić-Zdravčević ; School of Medicine, University J.J. Strossmayer in Osijek, Clinic Bagatin, Osijek, Croatia

Abstract

Spinal anesthesia is generally accepted as the first choice for hip surgery due to the deep nerve block affecting a large part of the body achieved through a relatively simple procedure of injecting a small amount of local anesthetic. By controlling the factors that influence the widening of the blocked area, the desired type of block can be achieved, the variability of which can be attributed to factors such as cerebrospinal fluid density, lumbar lordosis or volume of lumbosacral cerebrospinal fluid, namely, its dilution through the injection of isobaric anesthetic solution. However, it is important to know that in certain indications surgical anesthesia needs to be accomplished by a general endotracheal anesthesia. Spinal anesthesia of acceptable height and solidity is achieved through adequate intrathecal distribution of the local anesthetic solution, therefore the difference between the density of liquor and the injected solution of local anesthetic provides the main effect on the intrathecal spread of anesthetics. Anticipated spinal anesthesia is achieved by a hyperbaric or hypobaric solution of local anesthetic; in other words, hyperbaric solutions “sink” while the hypobaric solutions “swim” in such a way that the level of caudal or cranial spread of local anesthetic will depend on the mutual interaction of the density of the solution and the patient’s body posture.

Keywords

bupivacaine; hip arthorplasty; spinal anesthesia

Hrčak ID:

135691

URI

https://hrcak.srce.hr/135691

Publication date:

2.3.2015.

Article data in other languages: croatian

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