What is a spinal anesthesia?
Spinal anesthesia is a method for the stunning of spinal cord nerves. In contrast to other anesthesia procedures close to the back of the spinal cord, a drug is injected directly next to the nerves.
Thus, large areas of the body can be stifled in a short time while the patient remains fully conscious. Read all about the benefits of spinal anesthesia and when to perform it.
Spinal anaesthesia causes interruption of signal transmission in the nerves of the spinal cord. For this purpose, the doctor injects certain anesthetics into the cerebrospinal fluid space, which surrounds the spinal cord directly.
In addition to the pain, pressure and temperature sensitivity, the drug used also inhibits nerve fibers, which control the muscles and parts of the involuntary nervous system.
Because the spinal cord transmits all nerve signals from the trunk and the extremities to the brain, a spinal anesthesia can be used to numb large areas of the body from the legs to the chest. Until the feeling is switched off, it depends on what level of anesthetic acts on the spinal cord.
When is a spinal anesthesia performed?
Spinal anesthesia is used in many operations involving the legs, the pelvis or the abdomen. These include, for example, a number of orthopedic and urological procedures. Because spinal anesthesia makes the body less stressful than a general anesthesia, it is often a more gentle alternative. For example, it is preferred in patients with cardiovascular problems.
Spinal anesthesia can also be used in addition to a general anesthesia. This reduces the consumption of painkillers during and after the operation and the patients recover faster.
Finally, spinal anaesthesia is often used in obstetrics. On the one hand, pain relief in natural childbirth, and on the other hand as an anesthetic procedure for caesarean sections. Spinal anesthesia acts quickly so that even urgent operations can be performed promptly and does not pose a risk to the unborn child.
What is done with a spinal anesthesia?
In order to produce a spinal anesthesia, the doctor punctures with a thin needle in the region of the lumbar spine. He pushes it forward between two vertebrae and penetrates through several ligaments of the spine. Finally, it penetrates the hard spinal cord (dura mater) and reaches the space filled with cerebrospinal fluid (CSF), which surrounds the spinal cord.
The doctor knows that the needle is right and he can inject the drug. This usually happens once. However, a small plastic tube (catheter) can also be inserted into the cerebrospinal fluid space, which allows drugs to be administered over a longer period of time.
The nature and dose of the drug as well as the patient’s position determine the extent to which the spinal anesthesia acts. However, the anesthetic is always injected in the area of the lumbar spine. The patient is in the side or sitting position. The insertion of the needle is usually not painful since the doctor firstly anesthesia the puncture site. However, some patients experience an unpleasant feeling of pressure.
Already a few minutes after the anesthetic has been injected into the cerebrospinal fluid space, the patient usually first notice a feeling of warmth and tingling in the affected areas. After about 15 minutes, the spinal anesthesia has reached its full effect and the patient can be stored for surgery.
What are the risks of spinal anesthesia?
At the beginning of a spinal anesthesia, an effect on the cardiovascular system often manifests itself. Thus, in some patients shortly after the anesthetic has been injected, the blood pressure and the heart rate drop for a short time.
These symptoms may also be associated with nausea and vomiting. However, the doctor can counteract with special medicines.
Severe complications threaten when the anesthetic is inadvertently injected into a blood vessel or used too high doses. The drug then spreads throughout the bloodstream, or rises too high in the cerebrospinal fluid. In the worst case, this can lead to a heart attack or a breathing paralysis.
In the case of spinal anesthesia, some cerebrospinal fluid always flows out of the cerebrospinal fluid space, resulting in a slight vacuum. This may lead to a headache in the patient, which becomes more pronounced, especially in upright posture.
Where the physician has inserted the needle, a bruising can occur which compresses the spinal cord. This, as well as a direct injury of the nerve tissue through the needle, can lead to symptoms such as incontinence and paralysis symptoms. If the patient is taking blood thinners, he must place them under the doctor’s instructions in good time before the operation.
What do I have to consider after a spinal anesthesia?
After a spinal anaesthesia, do not drive a car for a day. In addition, you should stay in bed for some time with raised upper body and then only stand under supervision to avoid falls. If you experience headaches, backache, or nausea during this time, contact your doctor to discuss the possible side effects of spinal anaesthesia.