Intensive Care Management of Traumatic Spine Injury

Abstract

Acute spinal cord injury (SCI) causes neurological dysfunction and interrupts normal physiological regulatory patterns and requires anesthesia and neurocritical care management. Depending on the level of injury, airway stabilization can prove challenging, and maneuvers for laryngoscopy are more challenging prior to anesthesia induction because of restrictions related to stabilization of the cervical region from a cervical collar A preoperative evaluation of airway anatomy is crucial to determine the appropriate intubation methods. While there is no specific general anesthetic recommendation, attention should be given to maintain adequate spinal cord perfusion and prevent systemic hypotension. In addition, identifying presurgical neurologic dysfunction is important to properly assess for complications or further neuronal damage during the intraoperative period. This chapter identifies the important areas of perioperative management following acute SCI including anesthesia induction, hemodynamic challenges, fluid therapy, and postoperative pain management.