Anesthetic considerations in patients with cervical spine trauma

Abstract

Introduction: spinal cord trauma (MRT) is a public health problem that mainly affects the economically active population of low- and middle-income countries; Most of them caused by traffic accidents. Neurological damage can be primary by shearing, compression or distraction; By causing avulsion of the nervous tissue. It may also be secondary to laceration, contusion or ischemia; The latter due to hypotension or hypoxemia. Preventing and treating secondary lesions such as ischemia, hypotension, hypoxia and inflammation is an essential part of management. Objective: to perform a review in the scientific literature of the most important aspects involved in the MRT, the mechanisms of injury and the role of the anesthesiologist for both the airway approach and perioperative management. Material and methods: with the keywords, a non-systematic review was performed in the databases corresponding to OVID, Medline / PubMed, Science Direct. Results and conclusions: the initial management of the patient with MRT is fundamental in establishing late neurological outcomes. The perioperative goals are based on preventing the iatrogenic deterioration of an existing injury and limiting the development of a secondary lesion. The role of the anesthesiologist includes classification of the initial lesion, resuscitation in the acute phase, avoidance of secondary injury, and establishment of management plans involving airway approach.