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British Journal of Anaesthesia, 2003, Vol. 91, No. 6 886-904
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Review Article

Anaesthesia for spinal surgery in adults

D. A. Raw*,1, J. K. Beattie2 and J. M. Hunter1

1 University Department Anaesthesia, University Clinical Department, The Duncan Building, Daulby Street, Liverpool, L69 3GA, UK. 2 Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Road, Liverpool L7 8XP, UK

*Corresponding author. E-mail:daveraw@doctors.org.uk

Abstract

The spectrum of spinal surgery in adult life is considerable. Anaesthesia for major spinal surgery, such as spinal stabilization following trauma or neoplastic disease, or for correction of scoliosis, presents a number of challenges. The type of patients who would have been declined surgery 20 yr ago for medical reasons, are now being offered extensive procedures. They commonly have preoperative co-morbid conditions such as serious cardiovascular and respiratory impairment. Airway management may be difficult. Surgery imposes further stresses of significant blood loss, prolonged anaesthesia, and problematical postoperative pain management. The perioperative management of these patients is discussed. The advent of techniques to monitor spinal cord function has reduced postoperative neurological morbidity in these patients. The anaesthetist has an important role in facilitating these methods of monitoring.

Br J Anaesth 2003; 91: 886–904


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