Spinal anesthesia is very similar to epidural anesthesia–it affects a nerve block largely in the same fashion with the same types of medication as an epidural. However spinal anesthesia is differentiated from an epidural in several noteworthy ways. Unlike epidurals, spinal anesthesia is injected into the sub-arachnoid space where cerebro-spinal fluid is located. Spinal anesthesia involves a single injection rather than an indwelling catheter which stays in place to allow repeated dosing or a continuous infusion. Thus spinal anesthesia is most often used for surgical procedures of less than 3 hours in duration (including C-sections) and has limited usefulness for laboring women.
Spinal anesthesia is placed in the low back (lumbar region). After a sterile prep and draping, local anesthetic is placed on the skin to numb the area where the spinal needle will be advanced. The needle is passed between the vertebrae of the spinal column through the dural membrane where the cerebro-spinal fluid is located. Once the position of the needle is confirmed a local anesthetic and often a narcotic medication are injected and the needle is removed. The entire process usually takes approximately 5- 10 minutes and is somewhat less complex than the placement of an epidural.
Will I get a headache from spinal anesthesia?
The incidence of ‘post dural puncture headache’ in obstetric patients is currently estimated to be 0.5% to 1.5%. Just as there have been great advances in anesthetic medicines, much progress has also been made in the delivery of these medications. The risk of side effects has been greatly minimized by refinements in the size and shape of the needles used to administer spinal anesthetics. Most patients no long need bed rest following the spinal anesthesia, and the chance of post-operative headache and other side effects is equal to or lower than the risks from general anesthesia.
Do I always have an option of spinal or regional anesthesia?
No, some surgeries are not possible under spinal anesthesia. Additionally, some health-related conditions may preclude you from having a regional anesthetic. These include certain bleeding disorders, infections, spinal cord/neurologic disorders, and cardiac disorders.
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