![]() The vertebrae are stacked end to end with articulating joints and ligaments, and a hollow space running through them called the spinal canal. The different vertebral bones earn their names based on their relative positions and structural differences. The spine comprises seven cervical, 12 thoracics, five lumbar, and five fused sacral vertebral bones. The goal is to deliver appropriately dosed anesthetic into the intrathecal (subarachnoid) space. The administration of spinal anesthesia requires appropriate positioning and understanding of neuraxial anatomy. ![]() Spinal anesthesia is only performed in the lumbar spine for reasons which will be discussed later in this article, used for surgical procedures involving the lower abdomen, pelvis, and lower extremities. Other neuraxial techniques include epidural and caudal anesthesia, each having its particular indications. Approximately 500 mL of CSF gets produced daily. There are roughly about 130 to 140 mL of CSF in an adult human which continually cycles throughout the day. The subarachnoid space houses sterile cerebrospinal fluid (CSF), the clear fluid that bathes the brain and spinal cord. Spinal anesthesia is a neuraxial anesthesia technique in which local anesthetic is placed directly in the intrathecal space (subarachnoid space). The term neuraxial anesthesia refers to the placement of local anesthetic in or around the CNS. The central nervous system (CNS) comprises the brain and spinal cord. Before this, the only local anesthetic techniques were topical anesthesia of the eye and infiltration anesthesia. ![]() The first regional anesthetic technique performed was spinal anesthesia, and the first operation under spinal anesthesia was in 1898 in Germany by August Bier. The development of regional anesthesia started with the isolation of local anesthetics, the first being cocaine (the only naturally occurring local anesthetic). ![]()
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