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Info About Anesthesia

Spinal Anesthesia

Spinal anesthesia is placed in the low back (lumbar region). After a sterile prep and draping, local anesthetic is placed in the skin to numb the area where the Spinal needle will be placed. The Spinal needle passes between the vertebrae of the Spinal column through the dural membrane where the cerebrospinal fluid is located. Once the placement of the needle is accomplished medicines including a local anesthetic and sometimes a narcotic are dispensed via the needle. The needle is then removed. The entire process usually takes anywhere from 5- 20 minutes.

What is it like to have a Spinal? Is it painful?
In order to place the Spinal the patient must have a IV placed. The patient is placed on various monitors(pulse oximeter, BP, EKG). The patients are then positioned in either the sitting or lateral position. Once the local anesthetic is place in the skin there should be a pressure sensation when the Spinal needle is placed. As these needles are being placed sometimes a patient may feel a strong tingling in the area of the hip or shooting down the leg. This is usually only a transient sensation and should not alarm the patient. The anesthesiologist should be informed of this. It is important for the patient to hold still during the procedure as this greatly assists the physician in placement. Once the anesthetic has been placed the patient will begin to feel warming of the bottom and legs followed by loss of sensation of the involved area. This is followed by a loss of strength. The time period is anywhere from 5-25 minutes.

What are the risks of Spinal anesthesia?
The risks for Spinal anesthesia may include low blood pressure. Which is the reason the patient is routinely hydrated prior to the placement of either of these forms of anesthesia. Some of the time it is necessary to treat it with medication this is regularly by the anesthesiologist.

Postdural puncture headache occurs infrequently with these techniques. The risk is about 3% with Spinals. This is believed to be due to a leak of cerebrospinal fluid from the needle hole in the dura. The occurrence of this is greatly reduced by using a smaller needle when possible. If this headache does occur it may be treated initially with hydration and pain medicines. If the headache does not resolve it would be treated with an Epidural blood patch. This if essentially using the patients own blood to block the leak via the Epidural technique.

Backache is an infrequent problem. It most likely is due to ligament strain due to profound muscle relaxation or surgical positioning.

Other complications that can occur include, but are not limited to, infection, nerve damage(including paralysis, loss of bladder and bowel function, loss of sexual function), allergic reactions, seizures, cardiac arrest and death. Although the result of these are severe they occur very rarely.

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