Thoracic Segmental Spinal Anesthesia
Genti Shatri, Abhishek Singh
Abstract
Thoracic segmental spinal anesthesia is typically utilized for patients undergoing surgery with major medical problems where they are considered a greater risk for general anesthesia. General anesthesia is the standard for most surgeries; however, some drawbacks can include negative drug side effects, prolong recovery, and inadequate pain control. There is currently renewed attention to thoracic segmental spinal anesthesia for several common surgeries. Injection of anesthetics intrathecally into the preferred body height and above where the spinal cord terminates has been revealed to be valuable in these certain circumstances.Anesthesiologists are hesitant to perform spinal anesthesia above the termination of the conus medullaris due to fear of injuring the spinal cord. However, thoracic spinal anesthesia has been demonstrated as a safe and effective method for various surgeries, including laparoscopic cholecystectomies, breast cancer lumpectomies, and abdominal cancer surgery. Giving thoracic spinal anesthesia may provide another option for these common surgeries: improved patient safety, reduced postanesthesia care stay, and better postoperative pain relief. This review aims to describe the technique, indications, contraindications and highlight the role of the interprofessional team in the management of these patients undergoing thoracic segmental spinal anesthesia.