Anesthésie et recherche clinique
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Role of Anesthetists in Human Embryonic Stem Cells Transplantation in Patients with Spinal Cord Injury

Geeta Shroff, Nayan Sonowal and Avinash Mishra

Spinal cord injury (SCI) is a devastating disorder affecting millions across the world. Still, there is no standard approach for the treatment of SCI. The concept of regenerative medicine using the stem cells to repair tissues has become a reality of new era. Human embryonic stem cells (hESCs) have boosted as a new therapeutic strategy to treat SCI. The implantation of hESCs with reduced pain is the major concern for physicians. Our institute has been using specialized procedures to implant hESCs in a SCI patient via anesthesia techniques. The implantation of hESCs as well as the induction of anesthesia requires an employment of a skilled anesthetist. The authors focus on the novel approach, i.e., use of epidural and caudal routes for introduction of hESCs, as well as the role of an anesthetist in implantation of hESCs in the patients of SCI. An epidural injects hESCs into the region outside the duramater of the meninges whereas; hESCs implantation through the sacral membrane which is approximately three centimeters above the tip of the coccyx and is in continuum with the epidural space is achieved by caudal route. An anesthetist has an edge over the others due to his skills and knowledge regarding anesthetic agents, routes of administration as well as pain controlling strategy. He plays a significant role in hESC transplantation by evaluating a patient’s condition, protocol development along with a suitable health care management. Anesthetists might contribute to comprehensive patient care by encouraging the optimal use of multimodal regimens, as well as in implementing novel techniques, ensuring improvement in pain control and minimize adverse events.