Post spinal cord injury above T-7 70-75%, following the resolution of
spinal shock, 2-3 weeks after injury
Stimulation below the level of transection Severe HTN with bradycardia
A potential difficult A/W, unstable C-spine, aspiration risk (FOI), (RSI)
B respiratory reserve and volumes, risk of aspiration, pneumonia, PE,
respiratory failure PFT, ABG, post-op vent (ICU)
C hyperreflexia, orthostatic hypotension, assess the volume status. ECG,
D (Sux C/I), have anti-HTN ready (Niprid) N. stimulator show resistance
N deficit
Neuraxial best is a good choice but may be difficult to assess the level of
the block too high, or too low
Hyper-reflexia may happen post-op due to bladder or rectal distension.
Sequelae CV collapse, arrhythmias, pul edema, stroke, seizure, death