Standard textbooks should be consulted for specifictechniques and precautions for various spinal anesthetic procedures.
The safety and effectiveness of a spinal anesthetic dependupon proper dosage, correct technique, adequate precautions, and readinessfor emergencies. The lowest dosage that results in effective anesthesiashould be used to avoid high plasma levels and possible adverse effects.Tolerance varies with the status of the patient. Debilitated, elderlypatients, or acutely ill patients should be given reduced doses commensuratewith their weight and physical status. Reduced dosages are also indicatedfor obstetric delivery and patients with increased intra-abdominalpressure.
The decision whether or not to usespinal anesthesia in the following disease states depends on the physician’sappraisal of the advantages as opposed to the risk: cardiovasculardisease (i.e., shock, hypertension, anemia, etc.), pulmonary disease,renal impairment, metabolic or endocrine disorders, gastrointestinaldisorders (i.e., intestinal obstruction, peritonitis, etc.), or complicatedobstetrical deliveries.
NOVOCAIN SHOULD BE USEDWITH CAUTION IN PATIENTS WITH KNOWN DRUG ALLERGIES AND SENSITIVITIES.A thorough history of the patient’s prior experience with NOVOCAINor other local anesthetics as well as concomitant or recent drug useshould be taken (see CONTRAINDICATIONS). NOVOCAIN should not be usedin any condition in which a sulfonamide drug is being employed sinceaminobenzoic acid inhibits the action of sulfonamides.
Solutions containing a vasopressor should be used withcaution in the presence of diseases which may adversely affect thecardiovascular system.
NOVOCAIN should be usedwith caution in patients with severe disturbances of cardiac rhythm,shock or heartblock.