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Fred J. Spielman, MD; Charles B. Watson, MD

JAMA. 1983;249(6):734-736.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

SINCE its introduction by August Bier in 1898, subarachnoid spinal anesthesia has provoked more continuous controversy than any other anesthetic technique. The very mention of the procedure elicits a stress response from our patients and colleagues as they recall reports of complications ranging in severity from unremitting headache to irreversible paralysis after subarachnoid block. However, this relatively simple procedure is widely employed because of the excellent analgesia and muscle relaxation it provides and the absence of respiratory tract irritation and cardiac depression associated with its use in controlled situations.

Spinal anesthesia results from the temporary interruption of nerve transmission after injection of a local anesthetic solution into the subarachnoid space. The local anesthetic agents act on the spinal nerve roots and, possibly, the posterior and lateral areas of the spinal cord.¹ The rapidity of the onset of anesthesia is related to the diameter of nerve fibers. The smallest fibers . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill.

Footnotes
Reprint requests to Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, NC 27514 (Dr Spielman).

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