• Br J Anaesth · Jan 2023

    Review

    Defining the role of thoracic spinal anaesthesia in the 21st century: a narrative review.

    • Johannes J le Roux, Koji Wakabayashi, and Zainub Jooma.
    • Department of Anaesthesia, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: kobusleroux@hotmail.co.uk.
    • Br J Anaesth. 2023 Jan 1; 130 (1): e56e65e56-e65.

    AbstractSince the performance of the first thoracic spinal anaesthetic in early 1908 many anaesthetists have gained interest in this unorthodox neuraxial anaesthetic technique. The main rationale justifying its use is to prevent complications related to general anaesthesia in high-risk patient populations. There is, however, significant debate regarding this practice around the world. The main concerns are fear of iatrogenic injury to the spinal cord, cephalad spread of local anaesthetic causing a complete spinal block, and haemodynamic instability owing to blockade of cardioaccelerator sympathetic fibres. The purpose of this narrative review is to appraise the literature critically regarding thoracic spinal anaesthesia, to synthesise the available information, and to provide a summary of evidence justifying its use in modern anaesthesia.Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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