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April 2, 1960Journal of the American Medical Association

Long-Term Follow-Up of Patients Who Received 10,098 Spinal Anesthetics

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Why the study?

Does spinal anesthesia cause long-term neurological complications compared to general anesthesia in surgical patients?

Population

8,460 patients who received 10,098 injections of spinal anesthetics

Comparison

Spinal anesthesia vs General anesthesia or spinal anesthesia after…

Design

Cohort

Follow-up

long-term

Authors

LVLeroy D. VandamBrigham and Women's Hospital

Discussion

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Overview

Supports low severe neurological risk with spinal anesthesia; leaves open whether lumbar puncture technique drives minor persistent symptoms.

Key Points

  • To evaluate the long-term safety, neurological sequelae, and complication profile of spinal anesthesia compared to general anesthesia.
  • Reviewed records of 8,460 patients who received 10,098 spinal anesthetic injections.
  • Compared outcomes against 1,000 control patients receiving general anesthesia for similar operations and 100 patients receiving spinal anesthesia following general anesthetic induction.
  • No cases of adhesive arachnitis, transverse myelitis, or cauda equina syndrome occurred across the 10,098 spinal anesthetic injections.
  • Two patients experienced persistent symptoms and disabilities following unsuccessful spinal anesthesia attempts.
  • Seventeen patients developed post-procedure paresthesias and other neurological complaints following difficult lumbar punctures despite successful anesthetic delivery.

Structured PICO

Does spinal anesthesia cause long-term neurological complications compared to general anesthesia in surgical patients?

P
Population
8,460 patients who received 10,098 injections of spinal anesthetics
I
Intervention
Spinal anesthesia
C
Comparator
General anesthesia (n=1,000) or spinal anesthesia after induction with general anesthesia (n=100) for the same types of operations
O
Outcome
Long-term neurological complications (adhesive arachnitis, transverse myelitis, cauda equina syndrome)safety

Spinal anesthesia is generally safe from severe long-term neurological complications, though the lumbar puncture technique itself carries a small risk of persistent symptoms.

Cite This Study

Leroy D. Vandam (1960) studied this question.

synapsesocial.com/papers/6a0484cf3ec91c15297e8186https://doi.org/10.1001/jama.1960.03020140019005
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1NEUROPSYCHIATRIC COMPLICATIONS FOLLOWING SPINAL ANESTHESIA1945 · 10 citations
  2. 2A STUDY OF THE DEATHS ASSOCIATED WITH ANESTHESIA AND SURGERY1954 · 770 citations
  3. 3EXPERIMENTAL STUDIES ON HEADACHE1943 · 158 citations
  4. 4CARDIAC ARREST DURING ANESTHESIA AND SURGERY1949 · 69 citations
  5. 5LONG-TERM FOLLOW-UP OF PATIENTS WHO RECEIVED 10,098 SPINAL ANESTHETICS1954 · 270 citations