Total Spinal Anesthesia Failure: Have You Assessed the Sensory Anesthesia in Sacral Dermatomes?

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(Anesth Analg. 2017;124(5):1674–1677)Spinal anesthesia failure (SAF), which often results from intrathecal local anesthetic (LA) maldistribution, is sometimes managed with repeated spinal anesthesia (SA). In this brief report, the authors suggested that evaluation of sacral dermatomes before repeating SA can aid in the differentiation of total from partial SAFs, which in turn would lower the risks of neurotoxicity and safely guide subsequent anesthetic management.

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