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A fall of blood pressure accompanies each spinal anesthesia. It is the one possible danger associated with this form of anesthesia and may cause death. Its low point is usually ten minutes after the injection, and most fatalities have occurred at that time. After fifteen minutes, one is working away from the danger point, not toward it as in other general anesthetics. Given a reliable method of holding up blood pressure for the first fifteen minutes, and modern spinal anesthesia in trained hands is free of danger.
Epinephrin given intravenously is the only reliable drug in desperate cases of blood pressure collapse. Promptly and properly administered, it will hold every case until the body vasomotor tone is naturally restored. But the occasional near fatality which every user of spinal anesthetics has seen has resulted in the clinical trial of many drugs and measures to anticipate this blood pressure drop.
STEEL WA. BLOOD PRESSURE MAINTENANCE IN SPINAL ANESTHESIA. JAMA. 1925;84(2):79. doi:10.1001/jama.1925.02660280005002
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