Continuous spinal anaesthesia

Continuous spinal anaesthesia (CSA) is an infrequently used anaesthetic technique, where an intrathecal catheter (ITC) allows titrated injection of local anaesthetic into the intrathecal space to produce a subarachnoid block. Unlike single dose spinal anaesthesia (SDSA) where a fixed larger dose can result in an unpredictable block height and haemodynamic instability, titratable CSA allows lower doses to be used and the ability to extend the duration of anaesthesia if required. Currently, the most common anaesthetic use for an ITC is after an accidental dural puncture during the conduct of a labour epidural, the management of which has been covered in a previous essential notes article in this journal.1 This article instead discusses the indications, advantages, risks and technique of using an ITC to provide CSA.