Anestesia epidural segmentaria

Abstract

The authors report their experiences with segmental epidural anesthesia from a series of 110 cases. They make an anatomical and physiological study of the epidural space, and describe in full details the technique, the solutions to be employed, the instruments, the preparation, and the position of the patient, including the method of injection. In the same manner, they describe the time of appearance of the anesthesia, its duration, the reactions experienced by the patient, the effects of the anaesthetics accidents, and their results iu these 110 cases, and they come to the following conclusions. 1st The epidural anesthesia is difficult to practise, it requires a trained anaesthetist to do it. It is not possible to take into account the criticisms of the procedure by those, who have only done it a few times. The failures, the bad results, and the accidents are in inverse ratio to the experience of the operator. 2rd The «signo de la gota» «Drop sign» which with justice should be called «Sign of Albert Gutierrez», it constitutes a practical attainment of unquestionable value. 3rd The injection by retrogressive route is not advisible, because with it most of the accidents are seen. When the sub-arachnoid space is opened, it is advisable to withdraw the needle and to do a direct injection either above or below that point. 4th The arterial hypotension does not absolutely contraindicate its employment, if the patients are suitably prepared. 5th With epidural anesthesia one can undertake to anasthetize all territories of the organism except those innervated by cranial nerves.