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by Carson-DeWitt R

Spinal and Epidural Anesthesia

(Spinal Block; Epidural Block)

Definition

This type of anesthesia is placed near the spine area. It will block sensation like pain from the chest down to the legs.

Reasons for Procedure

Anesthesia is used to block pain. There are different types. Spinal and epidural anesthesia will allow you to be awake without feeling pain in lower body. It has fewer risks than general anesthesia. Spinal and epidural are most often used for:

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:
  • Severe headache or back pain
  • Drop in blood pressure
  • Nerve damage
  • Infection
  • Allergic reaction to the anesthesia medicine
  • Longer labor during childbirth with an epidural
Things that may increase the risk of problems include:
  • Smoking
  • Bleeding disorders
  • History of allergic reactions to anesthesia
  • Dehydration
  • Immune system disorders

What to Expect

Prior to Procedure

A specialist will talk to you before anesthesia is used. They will ask about:
  • Any drug allergies
  • Medicine you are taking
  • Health issues such as heart, lung, or bleeding problems
  • Any problems you have had with anesthesia

Description of the Procedure

Monitors will keep track of blood pressure, pulse, and oxygen levels in the blood. A tube may be passed up into the bladder. It will help to drain urine will the anesthesia is active. An area on the back will be cleaned. A medicine will be injected into the skin. It will numb the area for the spinal or epidural.
Spinal anesthesia: A needle will be passed into space around the spine. The medicine will be sent into the fluid that surrounds the spinal cord. It will be given in one injection.
Epidural anesthesia: A needle will be passed into space around the spine. The medicine will be sent into the fluid that surrounds the spinal cord. A tiny, flexible tube may be left in place just outside of the fluid sac. This will allow more doses to be given if it is needed.
A bandage will be placed over the area when the process is done.
Epidural Injection
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Immediately After Procedure

You will stay in bed until your legs are no longer numb.

How Long Will It Take?

It takes about 15 minutes to deliver a spinal or epidural.
  • Spinal anesthesia—begins working right away.
  • Epidural anesthesia—takes about 10 to 20 minutes to begin working.

How Much Will It Hurt?

You will feel some pain and pressure when the needle is inserted.

Average Hospital Stay

The hospital stay will depend on the reason anesthesia was needed.

Postoperative Care

Some activity, like driving, will need to be limited for the first 24 hours.

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. Call your doctor if you have:
  • Signs of infection, including fever and chills
  • Persistent or severe headache or back pain
  • Lightheadedness, fainting
  • Weakness, numbness, or tingling in your arms or legs
  • Loss of bladder or bowel control
  • Skin rash
  • Difficulty breathing
If you think you have an emergency, call for emergency medical services right away.

RESOURCES

American Society of Anesthesiologists
http://www.asahq.org
Family Doctor—American Academy of Family Physicians
https://familydoctor.org

CANADIAN RESOURCES

Canadian Anesthesiologists' Society
http://www.cas.ca
Health Canada
https://www. canada.ca

References

Epidural anesthesia. Baylor College of Medicine website. Available at: https://www.bcm.edu/healthcare/care-centers/anesthesiology/for-patients/epidural-analgesia. Updated August 2010. Accessed February 14, 2020.
Spinal anesthesia simulation. University of Florida website. Available at: http://vam.anest.ufl.edu/simulations/spinalanesthesia.php. Accessed February 14, 2020.
Regional anesthesia.https://www.bcm.edu/healthcare/care-centers/anesthesiology/for-patients/regional-anesthesia. Baylor College of Medicine website. Available at: https://www.bcm.edu/healthcare/care-centers/anesthesiology/patient-information/regional-anesthesia. Updated August 2010. Accessed February 14, 2020.
Spinal anaesthetic. Patient website. Available at: https://patient.info/health/spinal-anaesthetic. Updated August 17, 2017. Accessed February 14, 2020.
6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
12/30/2011 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T130450/Epidural-analgesia-during-labor : Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011;12:CD000331.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 09/2020
  • Update Date: 02/14/2020
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