Spinal Anesthesia: The Definitive Guide

Spinal anesthesia is used to keep patients out of pain during surgery.  Are you nervous about a spinal?

Most people do get a little nervous when they hear about spinal anesthesia.  They picture a huge needle going into their back and then think about all kinds of scary things.  But I will have to admit, I am fascinated by spinal anesthesia every time I use this technique.

Spinals are used to keep patients out of pain for a variety of surgeries.  They are commonly used as the sole anesthesia for cesarean sections.  In this way, the mom can remain awake for the delivery of her child by c-section, but not feel any part of the surgery.

Also, we can use spinal anesthesia for surgeries that take place anywhere from the belly button down to your feet.  Hip, knee, and foot surgeries are sometimes done under spinals.  Some prostate, bladder, and urologic surgeries are done under spinals.  And many times, a spinal anesthetic may be used with IV medicines so that you sleep during the procedure as well.  Your anesthesiologist will discuss these plans with you.

A spinal works by placing medicine into the space that surrounds the spinal cord and its nerves.  This is called the intrathecal space and contains cerebrospinal fluid (CSF).  If certain medicines are placed into the intrathecal space, then the nerves traveling from the spinal cord can be numbed for a certain length of time.

These nerves travel to your skin, bones, joints, organs, and other structures.  Many of these nerves carry pain sensation from your body to your spinal cord.  If we can place numbing medicine in the intrathecal space, then we can numb these nerves, effectively blocking your ability to feel pain.

Because nerves don’t just transmit pain, but also provide the ability for you to move your legs and feel temperature sensation (among other things), you lose the ability to move your legs effectively when you have had a spinal.  Don’t worry, this is expected.  Basically, the spinal will put the lower portion of your body to sleep for awhile.

But what about this needle going into my back?  We do use a needle to place the spinal, but there is no reason why you have to see it.  Really the needle isn’t that huge, but it doesn’t matter, because you don’t have to watch.  Also, we use numbing medicine to remove sensation from the skin of the lower back where the needle is inserted.

After the numbing medicine is used, most people don’t even feel the spinal needle going in.  They may feel a little pressure and that’s it.  If anything is uncomfortable after the initial numbing medicine, it may be a sign that the needle needs to be redirected a bit.  Your anesthesiologist will talk to you the entire time to make sure you know what is going on.  We are advocates for your safety and want you to be as comfortable as possible with anything that we do.

What about potential side effects?

One very rare complication called an epidural hematoma can potentially occur if a patient has a bleeding disorder or has been taking blood thinning medications.  This is why it is very important for the anesthesiologist to know about any medicines you are taking prior to placing the spinal.  Specifically, any medicines that the thin the blood or cause bleeding need to be discussed.  This includes aspirin, Plavix, heparin, Lovenox, herbal medicines, and a host of other meds. This complication is extremely rare.

Another potential complication that can be encountered is a post-dural puncture headache.  This can occur anytime a spinal anesthetic is used.  But because we use very tiny needles that have a pencil-like tip, the chances of a spinal headache are not as common as they used to be.  Post-dural puncture headaches usually resolve on their own or with oral medications, drinking fluids, and caffeine.  However, an anesthesiologist may perform a blood patch to help the headache resolve sooner.

Spinal medicines can also affect your vital signs, specifically your heart rate and blood pressure.  Don’t worry though, that is why your anesthesiologist is there with you during your spinal anesthetic.  He or she will watch your vital signs closely to treat any disturbances.

Truthfully though, once the spinal medicine has had a chance to wear off, it is extremely rare for there to be any lasting numbness from the spinal medicine.  This is unless of course, you had some type of numbness that was present prior to the spinal.

Thousands of patients everyday  have spinal anesthesia for c-sections and for other types of surgeries and do great.  If you have questions, don’t hesitate to ask your anesthesiologist about the spinal.  And look for a video and pictures soon on the actual placement of a spinal.

As always, feel free to leave comments below or visit our forum to talk with others about your anesthesia experience.

Thanks for stopping by!