Lambert et al. 1982; USA
Downs & Black = 13
Observational
N=50

Population: Subjects had injuries that were above T6, and complete; mean of 6.5 years post-injury.
Treatment: Retrospective review of 78 procedures. Three groups:
1) topical or no anesthesia sedation (n=19), 2) general anesthesia (n=13), and;
3) spinal anesthesia (n=46).
Outcome Measures: blood pressure

1. Intraoperative hypertension occurred more significantly with topical or no anesthesia (15/19) compared to general anesthesia (3/13) or spinal anesthesia (3/46).
2. Intraoperatively systolic BP increased significantly by 37 mmHg in patients receiving topical or no anesthesia. No significant difference in BP changes between general and spinal anesthesia groups (p=.114).

Eltorai et al. 1997; USA
Downs & Black = 4
Observational
N=591

Population: Level of injury: C1-T10, mean length of injury: 22.3 yrs
Treatment: retrospective review of anesthetic methods during surgery
Outcome Measures: blood pressure

1. AD occurred most commonly during the start of anesthesia (induction) with the greatest frequency when no anesthesia was provided.
2. During induction, systolic blood pressure increased in 68.7% of procedures during combined local anesthesia and intravenous (IV) sedation, in 65.4% of IV sedation alone, in 62.1% of local anesthesia alone, in 51.5% of spinal or epidural anesthesia, in 51.5% of general anesthesia, and in 88.8% of no anesthesia.