Professional paper - Review paper
Spinal anesthesia for hip surgery – particularities

Barković, Marina; Šurdonja-Bobinac, Aleksandra; Šakić-Zdravčević, Katarina (2015)
Metadata
Language English
Title (Croatian)Spinalna anestezija u kirurgiji kuka – posebitosti
Title (English)Spinal anesthesia for hip surgery – particularities
AuthorBarković, Marina
Šurdonja-Bobinac, Aleksandra
Šakić-Zdravčević, Katarina
Abstract (Croatian)
Općenito, spinalna anestezija predstavlja anesteziju izbora za operacije kuka radi dubokog nervnog bloka koji se postiže u velikim dijelovima tijela relativno jednostavnim injiciranjem male količine lokalnog anestetika. Upravljanjem čimbenicima koji utječu na širenje blokade dijela tijela može se pridonijeti željenom tipu spinalnog bloka, dok se velika varijabilnost pripisuje brojnim čimbenicima kao što su: gustoća cerebrospinalne tekućine, lumbalna lordoza ili volumen lumbosakralne cerebrospinalne tekućine, odnosno njezino razrjeđenje injiciranom otopinom izobaričnog anestetika. Stoga je vrlo važno da se, u pojedinim indikacijama, kirurška anestezija postigne općom endotrahealnom anestezijom. Spinalna anestezija dostatne visine i čvrstoće bloka postiže se dostatnom raspodjelom otopine lokalnog anestetika intratekalno, a razlika između gustoće likvora i injektirane otopine lokalnog anestetika ima glavni učinak na intratekalno širenje anestetika. Predvidljiva se spinalna anestezija postiže hiperbaričnom ili hipobaričnom otopinom lokalnog anestetika; ovdje se radi o gravitacijskom učinku, hiperbarične otopine “tonu” a hipobarične “plivaju” tako da će stupanj kaudalnog ili kranijalnog širenja, odnosno raspodjele lokalnog anestetika, zavisiti o uzajamnom djelovanju gustoće otopine i položaja tijela pacijenta.
Abstract (English)
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 (Croatian)artroplastika kuka bupivakain spinalna anestezija
Keywords (English)bupivacaine hip arthorplasty spinal anesthesia
Publication typeprofessional paper - review paper
Publication statuspublished
Peer reviewpeer review
Journal titleMedicina Fluminensis : Medicina Fluminensis
Numbering2015, Vol. 51, No. 1, pp 140-144
ISSN0025-7729
Datepublication: 02.03.2015.
Article URLhttp://hrcak.srce.hr/135691
Scientific fieldBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Orthopedics
InstitutionUniversity of Rijeka, Faculty of Medicine
(Department of Orthopedics and Physical Medicine)
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:318770