Assessment of spinal block adequacy

Abstract

This research presents a literature analysis of methods for evaluating the effec-tiveness of spinal anesthesia. The purpose of this analysis is to draw the attention of anesthesiologists to the issue of assessing the adequacy of neuraxial blockade and, in particular, spinal anesthesia, as the most commonly performed anesthetic management of surgical interventions. The adequacy of spinal anesthesia implies a pronounced motor block, which allows achieving complete relaxation of the muscles of the lower extremities and, if necessary, the muscles of the anterior abdominal wall, as well as the loss of pain, temperature and, as the most optimal level, this is the loss of tactile sensitivity. Considered methods for assessing motor, sensory and sympathetic blockade are P.R. Bromage scale to assess motor block, assessment of temperature and pain sensitivity (test with an ice tube, so-called Cold-test, test for pain sensitivity of the skin pin-prick). Until recently, in anesthesia practice, insufficient attention was paid to assessing the level of sympathetic blockade. The research describes an alternative method for assessing this type of blockade: laser doppler flowmetry. The quality and adequacy of spinal anesthesia will depend on the level and severity of these types of blockades.