Prevention of AD During General Surgery
Despite the partial or total loss of sensation below the level of injury, surgical procedures or manipulations can potentially initiate episodes of AD in people with SCI. Therefore, anesthesiologists and surgeons performing surgery on this population must be aware of the interactions and effects of the anaesthetic and how to prevent or manage AD during these procedures.
Discussion
Two observational studies (Lambert et al. 1982; Eltorai et al. 1997) presented evidence that AD is a common complication during general surgery in individuals with SCI. Up to 90% of people with SCI undergoing surgery with topical anesthesia or no anesthesia developed AD during the procedure. Both studies concluded that patients at risk for AD could be protected by either general or spinal anesthesia.
Conclusion
There is level 5 evidence (from 2 observational studies) (Lambert et al. 1982; Eltorai et al. 1997) that indicates that people at risk for autonomic dysreflexia are protected from developing intraoperative hypertension by either general or spinal anaesthesia.
