Always perform regional anaesth procedures in a properly equipped & staffed area w/ equipment & drugs necessary for monitoring & emergency resuscitation immediately available. IV access should be in place before starting intrathecal anaesth. Patients in poor general condition due to ageing or other compromising factors (eg, partial or complete heart conduction block, advanced liver or renal dysfunction) require special attention. Consider ECG monitoring in patients treated w/ class III antiarrhythmics (eg, amiodarone). May cause acute toxicity effects on the CNS & CVS if utilised for local anaesth procedures resulting in high blood conc (eg, unintentional intravascular administration). High or total spinal blockade resulting in CV & resp depression is a rare, though severe, adverse reaction following spinal anaesth. Patients w/ hypovolaemia can develop sudden & severe hypotension during intrathecal anaesth. Neurological injury is a rare consequence of intrathecal anaesth. Caution in patients w/ neurological disorders eg, multiple sclerosis, haemiplegia, paraplegia & neuromuscular disorders. May have a very mild effect on mental function & coordination & may temporarily impair locomotion & alertness. Reduce dose in the elderly & in patients in the late stages of pregnancy due to increased risk for high or total spinal blockade.
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