Abstract
The recent renaissance of spinal anesthesia is due, in no small part, to two factors. First is increased awareness of what the physiologic responses to spinal anesthesia consist of, especially cardiovascular responses. Second is the development of new concepts in cardiovascular physiology, especially appreciation of factors involved in regulation of myocardial oxygenation. To realize the full potential of spinal anesthesia requires full understanding of how and why spinal anesthesia affects cardiovascular function and what the cardiovascular responses to spinal anesthesia mean in terms of myocardial oxygenation (1).
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References
Space prohibits encyclopedic citation of the vast literature necessary to substantiate statements made and opinions expressed in this brief review. Instead, only 3 articles are cited and the reader is referred to the detailed discussions and extensive bibliography available in Chapters I and II of Greene, N.M., Physiology of Spinal Anesthesia, 3rd Edition, Williams and Wilkins, Baltimore, 1981.
Eckenhoff JE, Hafkenschiel JH, Foltz EL et al. Influence of hypotension on coronary blood flow, cardiac work, and cardiac efficiency. Am J Physiol 1948; 152:545–553.
Flackel DB, Sancetta SM, Kleinerman J. Effect of hypotension due to spinal anesthesia on coronary blood flow and myocardial metabolism in man. Circulation 1956; 13:92–97.
Sivarajan M, Amory DW, Lindbloom LE et al. Systemic and regional blood flow changes during spinal anesthesia in Rhesus monkeys. Anesthesiology 1975; 43:78–88.
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© 1984 Martinus Nijhoff Publishers, The Hague
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Greene, N.M. (1984). Concepts and Perspectives in Spinal Anesthesia. In: Van Kleef, J.W., Burm, A.G.L., Spierdijk, J. (eds) Current Concepts in Regional Anaesthesia. Developments in Critical Care Medicine and Anaesthesiology, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-6015-2_16
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DOI: https://doi.org/10.1007/978-94-009-6015-2_16
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