Post-Operative Care Following Spinal Anesthesia

Monitoring and Mobilization

The American Society of Anesthesiologists recommends assessing lower limb neurological function at regular intervals to detect any unexpected complications 1
The American Society of Regional Anesthesia and Pain Medicine suggests maintaining supplemental oxygen throughout the immediate recovery period 2, 3
Patients who have undergone spinal anesthesia should meet specific mobilization criteria, including return of sensation to the perianal area, plantar flexion of the foot, and return of proprioception in the big toe, before ambulation is allowed 4, 5, 6, 7

The European Society of Anesthesiology recommends restricting intravenous fluids to no more than 500 ml to reduce the incidence of urinary retention 4, 5, 7
The American Urological Association suggests that routine transurethral bladder drainage for 1-2 days is recommended for most surgical procedures 8

The American Society of Anesthesiologists recommends starting oral analgesics before the local anesthesia begins to wear off 6
The American Pain Society suggests providing premedication with oral analgesics, unless contraindicated, in addition to postoperative oral analgesics 4, 5
The American Society of Regional Anesthesia and Pain Medicine recommends avoiding opioid analgesics as the sole adjunct due to increased risk of respiratory depression and postoperative confusion 2, 3

The American Society of Anesthesiologists recommends that all patients must receive both verbal and written instructions, preferably in the presence of their responsible escort 4, 6, 5
The American Medical Association suggests that patients should not drive until pain or immobility from their operation allows them to control their car safely and perform an emergency stop 6

The American Geriatrics Society recommends that mild postoperative confusion is common and usually insignificant in elderly patients, and should not influence discharge if social circumstances permit 4, 6, 5
The American Society of Anesthesiologists suggests that lower doses of intrathecal bupivacaine (<10 mg) reduce associated hypotension in elderly patients 2, 3