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#36852 Spinal anaesthesia for awake lumbar spine surgery: a niche but emerging indication?
  1. Clara Lobo
  1. Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates


Spinal anesthesia for lumbar spine surgery is a technique that provides excellent operating conditions and patient satisfaction. The ability to avoid a general anesthetic and the requisite management of the airway is attractive to many patients. In contrast to the frequently-challenging period after emergence with spine surgery under general anesthesia, spinal anesthetic provides a ‘soft landing’ in the early postoperative period as the block of the lumbar area recedes slowly. In this lecture, I will discuss our experience with awake lumbar spine surgery under spinal anesthesia and provide perspective on several important considerations including:

  • What does ‘awake spine surgery’ really mean? Are all patients wide awake? Is some sedation ok? What sedative agents/plans are appropriate and safe in this setting?

  • Patient selection: Who CAN get awake spine surgery? Who should NOT be considered for awake spine surgery?

  • Communication with patient and surgeon: How to set expectations ahead of time with the patient, the surgeon, and the perioperative team?

  • Technique: The how, where, when and what of our intraoperative regimen with a recipe for success

  • Pitfalls: What can go wrong in awake spine surgery? How to predict and prepare for these

  • Outcomes: Why do we do this? Are we really making a difference? Here we discuss some of the important data that support the use of awake spine surgery in selected patients.

  • Spine surgery
  • regional anaesthesia

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