RT Book, Section
A1 Gaudet, John G.
A1 Lysakowski, Christopher
A2 Atchabahian, Arthur
A2 Gupta, Ruchir
SR Print(0)
ID 57262121
T1 Chapter 105. Spinal Surgery and Neurophysiologic Monitoring
T2 The Anesthesia Guide
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176049-2
LK accessanesthesiology.mhmedical.com/content.aspx?aid=57262121
RD 2024/04/19
AB Evaluation  of  risk  depends  on  several  factors:Elective  versus  emergent  versus  staged  surgeryOne  versus  several  vertebral  levelsPrimary  versus  repeat  procedureALL  cases  of  spine  surgery  associated  with:Risk  of  medullary  injuryRisk  of  significant  blood  lossRare  occurrence  of  significant  venous  emboli  (beware  if  PFO)Higher  prevalence  of  chronic  pain  and  drug  dependenceProne  positioning  associated  with:Cardiovascular  instabilityPositioning  injuries:  pressure  points  and  nerve  damage,  rarely  rhabdomyolysisVisual  lossDifficult  access  to  airwayPatients  with  previous  high  (above  T5)  spinal  cord  injury  (See  Chapter  32)Abnormal  autonomic  responses  (hypertensive  crisis  or  hypotension  and  bradycardia)Vasoplegia  (relative  hypovolemia)Atelectasis  from  inefficient  cough  and/or  hypoventilationBladder  spasticityCreatinine  does  not  correlate  with  renal  functionIntramuscular  injections  may  have  delayed  absorption