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