J.Jpn. Surg. Soc.. 55(9): 1018-1033, 1954
Original article
STUDY ON THE INTRASPINAL ABSORPTION OF THE ANESTHETICS IN CASES OF THE LUMBAR ANESTHESIA
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Department of Surgery, Tokyo Teishin Hospital (Chief: Dr. H. NAKATANI) Shinnosuke KURI |
2) The rate of the absorption of the intraspinal drug-solution depends upon the injected area and expanse of the drug in the spinal canal. The larger is the area of the expand, and the higher is the level of the injection, the faster is the rate of absorption.
3) The physiological circulation of the spinal fluid or the molecular expansion of the drug-solution have no influence on the spread of the drug-solution, but the removal of the solution caused by the gravity differences and by the change of the body position, have a large influence on it.
4) We perform the spinal anesthesia in the horizontal position on his side and let him lie down on supine position afterwards, but the effective concentration of the anesthetic never reach above cervical segment in that position, and in this stage we can find much amount of the drug in the blood.
So we may be able to say that some rapid absorption of the spinal anesthetic is being held at the site of the injection by that time.
5) It is possible that the anesthetic solution may be absorbd from outside of the dura mater (epidural space) leaking through the hole of the injection.
6) We can lengthen the time of spinal anesthesia by adding adrenalin to the anesthetic, because the drug-solution is hindered to go to the blood circulation.
So it is rational to add adrenalin in the case of operation of upper part of abdomen, in which anesthesia of high level segment is necessary and area of the expand of the solution is wide.
7) About the problem of postspinal headache, I could find that the primary causes are generally the lowering of the spinal fluid pressure by the leaking of the liquor through the dura mater after puncture.
(author's abstract)
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