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Spinal anesthesia blocks the transmission of pain signals up the spinal cord. This technique finds many applications in our operating rooms. It is often chosen for surgery involving the lower abdomen, legs, and feet, C-Sections in obstetrics, and for prostate surgery in men. After numbing a small area of your lower back, medicine is injected through a very small needle into the fluid filled sac below the end of your spinal cord. Local anesthetics, such as lidocaine , bupivicaine (Marcaine) or tetracaine, when given into this space, block the transmission of impulses along nerve pathways, preventing messages of pain from ever reaching the brain and also preventing the brain's movement commands from reaching the muscles in the affected body parts. Spinal anesthesia thus achieves desired numbness and immobility in the targeted area of the body, which provides your surgeon with good operating conditions. This loss of sensation usually develops from your lower rib cage down. Your anesthesiologist chooses the dose and type of drug depending on the patient's age, size, height, and the type of surgery. A small amount of narcotic medicine may also be added for longer term pain relief. Following the onset of numbness from spinal anesthesia, the patient may either stay awake for surgery, or more often intravenous sedation is given to achieve moderate sedation. Sometimes general anesthesia is given to supplement spinal anesthesia, giving the patient a deeper sleep.
The procedure of administering spinal anesthesia (also known as subarachnoid block) involves the insertion of a needle between the bones of the spine and into the spinal fluid. This is usually preceded by the injection of a local anesthetic to numb the area where the spinal will be inserted. The injection of the local anesthetic normally stings as it is injected, but most people do not have significant discomfort during the insertion of the spinal needle itself. Once the correct location of the needle has been determined, a small dose of medication is administered into the spinal fluid.
Advantages of Spinal Anesthesia
In certain cases, spinal anesthesia can have several advantages over general anesthesia. It may be the preferred choice for transurethral resection of the prostate, or "TURP," because it allows the patient to be awake enough to report certain symptoms that can give early warning of surgical complications such as fluid overload or bladder perforation. It is frequently employed in older patients that have orthopedic procedures such as surgery to repair a fractured hip because patients in this age bracket more frequently have co-existing medical conditions such as emphysema and heart disease. In addition, other patients may benefit from the use of spinal anesthesia because of it carries less risk of pulmonary reactions or postoperative nausea and vomiting.
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