Spinal and Epidural Anesthesia

Description of the Procedure Prior to receiving spinal or epidural anesthesia, the area of your back where the medicine is injected will be cleaned with a disinfectant solution. You may be given an injection of local anesthetic directly over the spot where the spinal or epidural anesthetic will be given, to decrease pain from the amesthetic needle. Spinal anesthesia involves a single injection of medication into the sac of fluid that surrounds your spinal cord. Epidural anesthesia may be given as a single injection just outside of the sac of fluid that surrounds your spinal cord. When more than one dose of epidural anesthesia might be required, the anesthetist will leave a tiny, flexible tube or catheter in place outside of the fluid sac surrounding your spinal cord. This way more anesthetic can be given easily if the operation takes longer than expected. Some surgical centers leave the epidural tube in place for 24 hours or more after surgery, using it to administer pain medications during the immediate postsurgical period. After the injection of spinal or epidural anesthesia has been completed, or after the epidural catheter has been removed, a small bandage will be placed over the area where the needle was withdrawn.

After Procedure After spinal anesthesia, youll be kept in bed with your head flat for several hours. This is to prevent you from developing a headache. After either spinal or epidural anesthesia, youll be kept in bed until your legs are no longer numb and its considered safe for you to walk. How Long Will It Take? Spinal anesthesia begins working nearly immediately after the injection is completed. Epidural anesthesia takes about 10 to 20 minutes to begin working. Will It Hurt? Needle insertion for either spinal or epidural anesthesia may be painful. The operation (or contractions during childbirth) should not hurt after receiving spinal or epidural anesthesia; you may, however, still feel pressure or tugging. Possible Complications Severe headache Drop in blood pressure Nerve damage Infection Allergic reaction to the anesthetic used Seizures Heart attack Average Hospital Stay Hospital stay will depend on the type of surgery being performed. Postoperative Care At the Hospital While you are recovering in the hospital, you will receive the following care: If youve received epidural anesthesia, and you need pain medicine after surgery, the epidural catheter may be left in place in order to continue supplying small doses of numbing anesthesia. When you no longer require pain control, the epidural catheter will be removed. If you have spinal anesthesia, youll be kept lying flat for a number of hours so that you dont develop a headache. If you have had epidural or spinal anesthesia, youll be kept in bed until you have sufficient feeling in your legs again to walk safely. At Home When you return home after the procedure, do the following to ensure a smooth recovery:

Do not drive or operate machinery for at least 24 hours after having received anesthesia Do not drink alcohol for at least 24 hours after receiving anesthesia Outcome Spinal and epidural anesthesia should numb you so that you dont feel pain during the course of your operation. Call Your Doctor If Any of the Following Occurs It is important for you to watch your recovery once you leave the hospital. That way you can alert your doctor to any problems. Call your doctor immediately if any of the following occur: Fever Persistent or severe headache Dizziness, fainting Weakness, numbness, or tingling in your arms or legs Skin rash Difficulty breathing RESOURCES: American Society of Anesthesiologists http://www.asahq.org National Library of Medicine http://www.nlm.nih.gov CANADIAN RESOURCES: BC Health Guide, British Columbia Ministry of Health http://www.bchealthguide.org/ Health Canada http://www.hc-sc.gc.ca/index_e.html References: Anesthesia: options and considerations. MayoClinic.com website. Available at: http://www.mayoclinic.com . Accessed September 16, 2003. Anesthetic techniques. Miller Anesthesia . 5th ed. St. Louis: Churchill Livingstone, Inc.; 2000. pp. 2223-2231.

Office-based anesthesia and surgery. American Society of Anesthesiologists website. Available at: http://www.asahq.org/patientEducation/officebased.htm . Accessed September 16, 2003. Regional anesthesia for postoperative pain control. Emedicine.com website. Available at: http://www.emedicine.com/orthoped/topic581.htm . Accessed September 16, 2003. X-Plain: epidural anesthesia. The Patient Education Institute, Inc. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/tutorials/epiduralanesthesia . Accessed September 16, 2003. Last reviewed January 2008 by Rosalyn Carson-Dewitt, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.