脊椎ジャーナル

Autonomic Hyperreflexia after Spinal Cord Injury

Abstract

Freda C Richa

The most important complication of spinal cord lesions above T6 level is the phenomenon of Autonomic Hyperreflexia (AH). Symptoms and signs of AH result from the predominant parasympathetic excitation above the level of injury, and sympathetic excitation below the level of injury. Various noxious and nonnoxious stimuli below the level of injury can thus trigger off a mass autonomic response. The main triggering factor of AH is related with the urinary tract. The main treatment of AH is removal of the triggering factors. The development of intraoperative AH and hypertension can be prevented either by general anesthesia, which blunts autonomic reflexes, or regional anesthesia (spinal or epidural), which blocks afferent and autonomic efferent neural impulses.