[Complications of spinal anesthesia and how to avoid them].

Spinal anesthesia is a safe procedure. The knowledge of complications may support efforts to minimize risks, speed up the recognition process and lead to adequate timely therapeutic approaches. Pain during insertion of the needle can be a warning signal for potential conus damage. Hypotension caused by spinal anesthesia should be treated by appropriate vasoactive drugs. Timely recognized cardiac arrest situations are usually well treatable. The incidence of postdural puncture headache should be less than 2% of cases. In case of a high degree of suffering the best currently available treatment is the epidural blood patch. Further complications like intracranial bleeding, infection, cauda equina syndrome or spinal hematoma need immediate differential diagnosis and therapeutic approaches. The residual risk for permanent harm can be estimated to be around 0,02 per thousand. Georg Thieme Verlag Stuttgart * New York.