Anaesthetic Management of Systemic Injuries Requiring Surgical Intervention in Patients With Spinal Shock

Abstract

Spinal cord injury is a devastating event, and patients who have suffered a spinal cord injury may present to trauma emergency services in spinal shock. This subset of patients is likely to have concomitant systemic injuries, which may often require surgical interventions. All trauma patients should get sufficient pre-hospital care, including adequate measures to immobilize the spine. Because multiple organ systems are involved in these patients with spinal shock, anesthetic management for systemic injuries requiring surgery is challenging and necessitates a thorough understanding of the pathophysiology. The main goals of perioperative management are to provide oxygenation and maintain spinal cord perfusion to prevent secondary spinal cord injury while providing supportive care. Airway management invites a trained anesthesiologist to secure the airway while maintaining cervical spine immobilization. In this article, we review anesthetic considerations in managing spinal cord injury patients with systemic injuries in spinal shock requiring surgical interventions.