Utilising high-volume spinal anaesthesia as an alternative to general anaesthesia: lessons from Gaza

The scarcity of medical resources available amidst the Israeli military assault on Gaza necessitates innovative approaches to healthcare delivery. The downstream humanitarian catastrophe, a direct consequence of the blockade of the Gaza Strip, which has tightened over the last 18 months, has resulted in shortages of basic medical supplies and equipment, with pallets of aid trucks stuck at checkpoint crossings indefinitely and limited amounts of supplies permitted intermittently. Such resource scarcity, coupled with the widespread destruction of civilian infrastructure and hospitals, including the abduction, torture, and killing of healthcare workers and trained specialists, has driven the remaining local medical professionals to adapt by developing innovative techniques to ensure patient safety during surgery. A previous study of Médecins Sans Frontières (Doctors Without Borders) services found that spinal anaesthesia was the most common anaesthesia technique in resource-limited settings. One such spinal technique, specifically high-volume spinal anaesthesia (HVSA), emerged as a practical alternative to general anaesthesia under constrained circumstances.