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Spinal Anesthesia

Overview

Spinal anesthesia, also known as spinal block or subarachnoid block, is a type of regional anesthesia that involves injecting anesthetic agents into the subarachnoid space in the lower back, affecting the spinal nerves. This technique is commonly used for surgical procedures in the lower abdomen, pelvis, and lower extremities.
Spinal anesthesia provides a rapid onset of sensory and motor block, allowing for effective pain management during and after surgery. It is widely used in various surgical settings, including orthopedic, urological, and obstetric procedures (e.g., cesarean section).

Specialty

  • Anaesthesiology: Spinal anesthesia falls under the specialty of anaesthesiology. An anesthetist or anaesthesiologist performs the procedure, requiring expertise in regional anesthesia techniques.
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Dr. Deepak Chablani
Senior Consultant
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Sanjeev Kr. Nangia
Dr. Sanjeev Kr. Nangia
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Sukriti Prakash
Dr. Sukriti Prakash
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How is Spinal anesthesia done?

Patient Assessment:
  • Medical history, including allergies and previous anesthesia experiences.
  • Physical examination focusing on spinal anatomy and neurological status.
Informed Consent:
  • Discuss the procedure, benefits, risks, and alternatives with the patient. Obtain written consent.
Preoperative Instructions:
  • Fast according to institutional guidelines.
  • Pre-medications may be administered as required (e.g., anxiolytics).
Equipment Preparation:
  • Anesthesia cart with spinal needles, syringes, local anesthetic agents (e.g., bupivacaine, lidocaine), and additional medications (e.g., opioids, adjuvants).
  • Monitoring equipment (blood pressure, pulse oximetry, ECG).
Positioning:
  • Ensure the patient is positioned comfortably (sitting or lateral decubitus) to facilitate spinal access.

  • Positioning: The patient is positioned appropriately to expose the lower lumbar region.
  • Aseptic Technique: Sterilize the skin using antiseptic solutions.
  • Local Anaesthetic Administration: Administer a local anesthetic to numb the skin and underlying tissues at the chosen injection site (typically L3-L4 or L4-L5 interspace).
  • Needle Insertion: Insert a spinal needle through the skin and into the subarachnoid space. The “pop” felt when entering the space indicates successful entry.
  • Administration of Anaesthetic: Inject the desired dose of the spinal anesthetic slowly while monitoring the patient.
  • Monitoring: Continuous monitoring of vital signs and neurological status during the procedure and recovery.

While spinal anesthesia is generally safe, potential complications may include:

  • Hypotension: Due to sympathetic blockade leading to vasodilation.
  • Post-Dural Puncture Headache (PDPH): Caused by cerebrospinal fluid leak.
  • Infection: Risk of meningitis or abscess.
  • Nerve Injury: Rare, but possible during needle insertion.
  • Urinary Retention: Temporary inability to urinate post-procedure.
  • Allergic Reactions: To anesthetic agents used.
What are the benefits of Spinal Anesthesia
  • Rapid Onset: Immediate effect of pain relief.
  • Reduced General Anaesthesia Risks: Lower risk of airway complications and aspiration.
  • Postoperative Pain Relief: Extended analgesia can be achieved with the right agents.
  • Minimal Systemic Effects: Compared to general anesthesia, it has fewer systemic effects on the body.

Infrastructure Facilities

  • Anesthesia Equipment: Availability of spinal needles, monitoring devices, and emergency drugs.
  • Recovery Area: Facilities for post-anesthesia recovery and monitoring.
  • Surgical Suite: Must be equipped with appropriate surgical and anesthetic infrastructure.
  • Emergency Protocols: Clear protocols for managing complications.

FAQs

The duration can vary depending on the type of anesthetic used but typically lasts between 1-3 hours.

Yes, patients are often awake and can communicate, though they will not feel pain in the targeted area.

While there are risks associated with spinal anesthesia, serious complications are rare, and it is generally considered safe for appropriate candidates.

Mobility is usually restricted immediately after spinal anesthesia until the block wears off. Patients should follow the anesthetist's instructions.

Communicate your concerns to the anesthetist, who can help alleviate anxiety and provide support during the procedure.

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Copyright 2025 TRSCH - All Rights Reserve

Website Design and Development by Sterco Digitex

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