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Spinal anesthesia simulates shock, and for that reason the author is uncertain as to whether or not it should be used. He carried out experimental clinical investigations and thoroughly reviewed the literature. Many definitions of shock are presented and one definition was decided on for this investigation. The influence of spinal anesthesia on certain circulatory factors, namely, (1) the oxygen consumption, (2) the arterial-venous oxygen difference, (3) the cardiac output per minute and per beat, (4) the venous pressure, (5) the circulating blood volume and (6) the capillary picture, are considered, together with the influence on respiration of spinal anesthesia involving the thoracic but not the cervical part of the spinal cord. The animals, in most instances, were narcotized with urethane and pernocton. The spinal anesthetic agent was procaine to which a dye had been added. Not all the factors concerned in the experiments have been explained. Debatable points are
On the Disturbance of the Circulation in Spinal Anaesthesia: An Experimental Study. JAMA. 1936;107(24):1995. doi:10.1001/jama.1936.02770500061029