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Anesthesia for adults with acute spinal cord injury

Authors
Letha Mathews, MBBS, FFARCS (I)
Lorri A Lee, MD
Section Editor
Jeffrey J Pasternak, MD
Deputy Editor
Marianna Crowley, MD

INTRODUCTION

Spinal cord injury (SCI) is a common, often devastating event, with approximately 12,000 new cases in the United States each year.

This topic will discuss anesthetic management in the operating room (OR) for adults with acute SCI. Diagnosis, emergency department (ED) management, medical therapy, and anesthesia for patients with chronic SCI are discussed separately. (See "Evaluation and acute management of cervical spinal column injuries in adults" and "Acute traumatic spinal cord injury" and "Chronic complications of spinal cord injury and disease" and "Respiratory physiologic changes following spinal cord injury" and "Respiratory complications in the adult patient with chronic spinal cord injury" and "Anesthesia for adults with chronic spinal cord injury".)

For the purpose of this discussion, the acute period will be defined as the first several weeks after the injury.

SYSTEMIC EFFECTS OF ACUTE SPINAL CORD INJURY

In addition to neurologic injury, cervical and upper thoracic acute spinal cord injuries (ASCIs) are associated with cardiovascular and pulmonary complications that affect the plan for anesthetic management.

Spinal shock — Spinal shock and neurogenic shock are two distinct entities:

                        

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Literature review current through: Nov 2016. | This topic last updated: Tue Jan 26 00:00:00 GMT 2016.
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