REVIEW OF NEURAXIAL TECHNIQUES IN ANAESTHESIA: RISKS, CAUSES, AND RECOMMENDATIONS FOR SPINAL CORD INJURIES
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Abstract
Neuraxial procedures, including spinal and epidural anesthesia, may carry potential complications. Although rare, spinal cord injuries resulting from anesthetic practices (referred to as Anaes-SCI remain a significant concern for surgical patients. This systematic review aims to identify high-risk patient profiles, summarize the causes and consequences of SCI associated with neuraxial techniques in anesthesia, and provide management recommendations. A comprehensive literature search was conducted in accordance with Cochrane guidelines, and specific inclusion criteria were employed to identify relevant studies. Of the initial 384 studies screened, 31 underwent critical appraisal, and their data were extracted and analyzed. The findings of this review indicate that the primary risk factors for Anaes-SCI were extreme age, obesity, and diabetes. Anaes-SCI resulted from various causes, including hematoma, trauma, abscess, ischemia, and infarction, among others. The consequences predominantly included motor deficits, sensory loss, and pain. Delayed treatment for Anaes-SCI was frequently reported. Despite the potential complications, neuraxial techniques continue to be among the preferred choices for opioid-sparing pain management, contributing to reduced patient morbidity, improved outcomes, shorter hospital stays, and prevention of pain becoming chronic, with associated economic benefits. This review underscores the importance of meticulous patient management and close monitoring during neuraxial anesthesia procedures to minimize the risk of spinal cord injury and associated complications.
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References
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