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Abstract
Continuous spinal anaesthesia is the technique of producing and maintaining spinal anaesthesia with small doses of LAs injected intermittently into the subarachnoid space via a catheter.
The level of the blockade is established gradually, a method that greatly reduces the possibility of high spinal anaesthesia and decreases the likelihood of cardiovascular instability. The continuous spinal technique assures safe and adequate spinal anaesthesia and analgesia.
The CSF supports and protects the brain and the spinal cord. CSA is used for operations below the umbilicus. The lateral decubitus and the sitting position can be used during applying the blockade. Complications of CSA include arterial hypotension, backache and PDPH. Ropivacaine is indicated for the production of local and regional anaesthesia. It should be discontinued at the first sign of toxicity and treatment should be symptomatic. Intrathecal morphine for pain control was shown to provide effective analgesia. Side effects include respiratory depression, nausea, vomiting and pruritus. The stress response to surgery is characterized by increased secretion of pituitary hormones and activation of the sympathetic nervous system. Central neuraxial blockade may attenuate this response. The study was conducted at Ain-Shams University hospitals on 60 patients scheduled for elective lower extremity surgery expected to exceed 3 hours in duration. A 20G catheter was inserted 3-4 cm cephalad into the subarachnoid space at the L4-L5 or L3-L4intervertebral space. 1mL of ropivacaine hydrochloride (0.75%) was injected intrathecal. Titration with 0.5ml incremental boluses of the same ropivacaine hydrochloride solution until sensory blockade reached at least dermatome T10.