Contraindications
Spinal anaesthesia should not be attempted in the following situations:
- skin infection over the likely site of spinal needle insertion
- pre-existing bleeding diathesis or anticoagulation: haemorrhage may put pressure on the cord
- skeletal deformity or ossification of spine
- cardiovascular compromise:
- shock or hypovolaemia - decreases blood pressure further
- states of fixed cardiac output, e.g. aortic stenosis - patient is unable to adapt to stresses of hypotension
- neurological conditions - deterioration postoperatively may be blamed on the anaesthesia
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