Anesthesia for cervical spinal cord injury

Apolonia E. Abramowicz, Maria Bustillo

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Anesthesiologists are involved in the care of acute cervical spinal cord injury (SCI) patients related to blunt and penetrating trauma, as well as perioperative injuries resulting from spine surgery and/or preexisting spondylosis. Knowledge of the ASIA injury scale classification and epidemiology of associated injuries helps the anesthesiologist to prioritize management of these complex patients according to the most recent guidelines. Steroids should no longer be used as neuroprotective agents. Early surgical decompression and spinal stabilization is gaining favor. Manual in-line stabilization remains recommended while cricoid pressure during intubation is not. Videolaryngoscopes are increasingly utilized, but fiberoptic intubation remains the gold standard when applicable. Neurogenic shock requires attentive hemodynamic and bradyarrhythmia management. Central neuropathic pain is a common and difficult to manage entity in SCI.

Original languageEnglish (US)
Title of host publicationAnesthesia for Trauma
Subtitle of host publicationNew Evidence and New Challenges
PublisherSpringer New York
Pages167-192
Number of pages26
ISBN (Electronic)9781493909094
ISBN (Print)1493909088, 9781493909087
DOIs
StatePublished - Mar 1 2014

Keywords

  • airway instrumentation
  • anesthetic management
  • cervical spinal cord injury
  • complications of cervical spine surgery
  • respiratory and hemodynamic management

ASJC Scopus subject areas

  • Medicine(all)

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