Spinal anaesthesia
Spinal anesthesia is a regional anesthesia technique that blocks pain and sensation from the lower half of the body, commonly used during surgical procedures like Cesarean sections, hip surgeries, and urinary tract operations. Unlike general anesthesia, spinal anesthesia does not induce unconsciousness, allowing patients to remain aware and responsive, often with minimal sedation provided for comfort. The procedure involves injecting medication into the cerebrospinal fluid surrounding the spinal cord, which quickly numbs the targeted areas. The administration is usually performed while the patient is sitting or lying on their side, and often requires only one injection to achieve the desired effect.
Spinal anesthesia is preferred in many cases due to its lower incidence of side effects compared to general anesthesia, enabling faster recovery times and less need for pain medication afterward. However, it is not without risks; potential side effects can range from mild reactions, such as temporary eyelid drooping or nasal congestion, to more serious complications like difficulty breathing or pneumothorax. Patients are encouraged to discuss their medical history and any medications they are taking with their healthcare providers prior to receiving spinal anesthesia. Recovery involves monitoring for any side effects, and patients are typically advised to rest until they regain full mobility. Overall, spinal anesthesia is a valuable option in modern medical practice for specific lower-body surgical interventions.
On this Page
Spinal anesthesia
Spinal anesthesia is a form of anesthesia that blocks pain from the lower half of the body. It is primarily used during medical procedures such as surgeries. Spinal anesthesia is a form of regional anesthesia that does not sedate patients but blocks sensation. This type of anesthesia is administered by injecting medications near specific nerves in the body. Spinal anesthesia and other types of regional anesthesia are often favored for some types of surgery because they generally have fewer side effects than general anesthesia. Spinal anesthesia is used for several different procedures, such as back or hip surgery, urinary tract surgery, or Caesarean section.
Background
Anesthesia is a temporary loss of sensation or awareness induced by medical professionals to perform invasive procedures such as surgery. Most often, patients who undergo anesthesia for surgery are given general anesthesia, which keeps a patient unconscious and free of pain throughout a medical procedure. General anesthesia is most often administered through medications that are administered intravenously or inhaled. A person receiving general anesthesia will not regain consciousness until after the medical procedure is finished. General anesthesia is an effective method for keeping patients immobile and free of pain during medical procedures. However, it can have several side effects and complications.
Some medical procedures can be performed with regional, or local, anesthesia, which is a type of anesthesia that that numbs a specific area of the body. Regional anesthesia is usually given by administering injections of a medication that affect specific nerves, preventing patients from feeling sensations in a particular region. People may or may not be sedated when they receive regional anesthesia. Spinal anesthesia is a common type of regional anesthesia.
Overview
Patients who receive spinal anesthesia are administered the medication when they are sitting up or lying on one side. The medical team, which includes an anesthesiologist, nurses, and other physicians, cleans and prepares an area on the patient’s back over the spinal cord. The team may first administer a local anesthetic in the area to reduce the pain from the injection of the spinal anesthesia. The main injection is administered through a small needle. The needle is placed directly into the cerebrospinal fluid that surrounds the spinal cord. The drugs that are used stop sensation below and sometimes above the injection. The medication also numbs nerves that travel to the stomach, hips, and legs. Sometimes the needle can touch nerves, which can cause patients to feel tingling in their lower extremities. Unlike some other types of regional anesthesia, patients usually need only one injection for spinal anesthesia. The medication begins to act almost immediately.
People who receive spinal anesthesia are often administered intravenous (IV) lines that provide them with fluids and other medications during medical procedures. These lines can also be used to administer medications that sedate patients. Some patients receive minimal sedation that helps keep them calm and sleepy, but not totally unconscious. This allows them to react to the medical teams’ instructions or requests. Other patients who receive sedatives are deeply sedated and sleep through their procedures. They do not react to questions, and they have no memory of the procedure. Medical teams closely monitor patients who receive spinal anesthesia. They will monitor patients’ blood pressure, oxygen levels, and pulse.
Spinal anesthesia generally has fewer side effects than general anesthesia. Patients might experience a reaction called Horner's syndrome, which causes a change to the size of the pupils in their eyes. Another common side effect is a slight drooping of the eyelid called ptosis. These reactions are fairly common and will generally go away after the medication wears off. Other common side effects include nose congestion and voice hoarseness.
More serious side effects include a feeling of struggling to breathe, which can occur if the anesthesia affects the nerves of the diaphragm. Another possible serious side effect is pneumothorax, a condition where air is trapped between the lung and rib cage. Patients who develop this side effect will usually experience chest pain and coughing. After a diagnosis is made through an X-ray, doctors will insert a chest tube to release the excess air and allow the patient to breathe normally. Some patients also experience bruising or bleeding at the injection site.
Spinal anesthesia has some distinctive benefits over general anesthesia. This type of anesthesia generally gives patients better pain control than IV drugs supplied with general anesthesia. Patients also generally recover more quickly from spinal anesthesia than from general anesthesia. They often recover bowel function more quickly and need less overall medication during the procedure.
Before patients receive spinal anesthesia, they should discuss their current health conditions with their medical providers. They should also reveal any allergies they have toward specific types of medication. Before the procedure, patients should also prepare by reducing and stopping certain medications, such as blood thinners. They may also be asked to stop eating or drinking by a particular time the night or day before the procedure. After the medical procedure, patients are advised to remain in bed until their legs are strong enough for them to walk. Some patients also need medications to recover from nausea or dizziness. Patients also generally have to urinate before they can be discharged after the procedure.
Spinal anesthesia is common for particular types of medical procedures, especially procedures that take place below the waist. Gastrointestinal, hepatic (liver), gynecology, urology, and some types of orthopedic surgeries can all be treated using spinal anesthesia.
Bibliography
Chin, Adrian, and André van Zundert. “Spinal Anesthesia.” New York School of Regional Anesthesia, 2021, www.nysora.com/techniques/neuraxial-and-perineuraxial-techniques/spinal-anesthesia/. Accessed 3 Feb. 2021.
Cyriac, James. “Spinal and Epidural Anesthesia.” Medline Plus, 5 Jan. 2021, medlineplus.gov/ency/article/007413.htm. Accessed 3 Feb. 2021.
“Epidural and Spinal Anesthesia.” Healthwise, 21 Aug. 2019, www.uofmhealth.org/health-library/rt1583. Accessed 3 Feb. 2021.
Fettes, P. D. W., J. R. Jansson, J. A. W. Wildsmith. “Failed Spinal Anaesthesia.” British Journal of Anaesthesia, vol. 102, no. 6, 2009, pp. 739–748.
Olawin, Abdulquadri M. and Joe M Das. “Spinal Anesthesia.” StatPearls Publishing, 13 Oct. 2020, www.ncbi.nlm.nih.gov/books/NBK537299/. Accessed 3 Feb. 2021.
Rattenberry, W., et al. “Spinal Anaesthesia for Ambulatory Surgery.” British Journal of Anaesthesia, vol. 19, no. 10, 2019, pp. 321–328.
“Regional Anesthesia for Surgery.” American Society of Regional Anesthesia and Pain Medicine, 2021, www.asra.com/page/41/regional-anesthesia-for-surgery. Accessed 3 Feb. 2021.
“Risks and Benefits of Regional Anesthesia.” American Society of Regional Anesthesia and Pain Medicine, 2021, www.asra.com/page/43/risks-and-benefits-of-regional-anesthesia. Accessed 3 Feb. 2021.