The most common cranial nerve involved in spinal anesthesia
cranial nerve VI is most commonly affected during spinal Anaesthesia. Dural puncture - a critical step in performing spinal anesthesia - was first introduced by Quinke in 1891, and sholy thereafter, Bier repoed the first case of post-dural puncture headache (PDPH). Bier proposed that ongoing leakage of cerebrospinal fluid (CSF) causes the headache, ie, leakage of CSF through the dural puncture site exceeds the rate of CSF production and results in low CSF pressure. Magnetic resonance imaging has confirmed that this leads to intracranial hypotension with descent of the brain, thereby causing traction of the sixth cranial nerve and pain-sensitive structures. The stretching of the nerve is thought to cause local ischemia as well as nerve dysfunction and can be seen in association with other signs of intracranial hypotension such as veigo, nausea, and vomiting.
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Central Neuraxial Blockade