SPINAL-ANESTHESIA - PRACTICAL APPLICATIONS

The recent widespread popularity of spinal anesthesia can be traced to two events. One is the appreciation that, when used for operations be low the level of the umbilicus, anesthetically induced physiologic tre spass is less with spinal than with general anesthesia. The other is t he recognition that modest hypotension with peripheral vasodilation, t hat may be seen with spinal anesthesia or intravenous infusion of nitr oprusside, is, unlike hypotension associated with hypovolemia, unaccom panied by physiologically significant changes in peripheral distributi on of cardiac output or changes in the balance between tissue oxygen s upply and demand in the myocardium or elsewhere. Spinal anesthesia als o has special advantages specific to urinary tract surgery in the geri atric patient.