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SPINAL ANESTHESIA AND SURGICAL SHOCK

HARRY KOSTER, M.D.; ARTHUR SHAPIRO, M.D.; AARON GOLDBERG, B.S.
Arch Surg. 1941;42(4):795-800. doi:10.1001/archsurg.1941.01210100155014.
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A marked fall in blood pressure during an operation with general or local anesthesia is usually accepted as an indication of severe hemorrhage, surgical shock or both. This has led many surgeons to believe that the fall in blood pressure which regularly accompanies the induction of spinal anesthesia has equally grave significance. On the basis of the same kind of reasoning, various technics have been introduced either to prevent the fall in blood pressure or to raise the pressure after it has reached what is considered a dangerously low level, and it has been argued that spinal anesthesia is contraindicated in the presence of the hypotension secondary to traumatic shock, hemorrhage and peritonitis.

On the other hand, in a previous report one of us (Koster1) concluded, on the basis of 3,500 experiences with spinal anesthesia, that the fall in blood pressure, no matter how marked, is not of great

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