CONTINUOUS SPINAL-ANESTHESIA - THE CANADIAN PERSPECTIVE

Background and Objectives. Until the arrival of microcatheters, contin uous spinal anesthesia was mainly restricted to elderly and high-risk patients. The introduction of microcatheters enabled the technique to be used in a wider range of patients. This paper describes the experie nces of anesthetists in Canada with these catheters, and the changes i n their practice since their withdrawal. Methods. Anesthetists (those known to have experience with continuous spinal anesthesia, or to be r egional anesthesia enthusiasts) across Canada were surveyed by telepho ne or mad. Results. Of a total of 36 respondents, 25 had tried continu ous spinal anesthesia with microcatheters. The majority had experience of only a few cases, but a few reported larger series of hundreds of cases. Numerous technical difficulties with catheter insertion occurre d, and problems with catheter breakage and neurologic deficit were rep orted. Some of these problems were reported to the Health Protection B ranch, and, as a result of these reports and problems experienced in t he United States, microcatheters were recalled in Canada soon after th e FDA safety alert in the United States. Conclusions. Various techniqu es are being used instead of continuous spinal anesthesia with microca theters, and only a few anesthetists favored their return.