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What is Spinal Anesthesia?
Spinal anesthesia involves injecting small amounts of local
anesthetic into the cerebro-spinal fluid. The lumbar spine
below the level at which the spinal cord ends is where the
injection is usually made.
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Effects of Spinal Anesthesia
Patients undergoing surgery with spinal anesthesia have the
ability to be awake during the operation and avoid
complications associated with general anesthesia. Based on
research, the patients who receive spinal anesthesia lose
less blood during surgery and have much better pain control
after it.
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Candidates for Spinal Anesthesia
Spinal anesthesia is ideal for patients undergoing surgery
involving the pelvis, hips, and legs, and can also be
administered during childbirth.
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Your
Consultation
Before the procedure, the patient should inform the doctor
of his drug allergies, medications he is taking, any heart
or lung conditions, any previous reactions to anesthesia and
also any bleeding problems in the past.
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The Spinal Anesthesia
Procedure
The patient will receive an intravenous line (IV) and be
placed on various monitors to keep track of the blood
pressure, pulse and the blood’s oxygen content. Then the
patient will be placed in either the sitting or lateral
position. When the local anesthetic is placed in the skin,
there should be a pressure sensation when the spinal needles
are placed. The patient may feel a strong tingling in the
area of the hip or shooting down the leg as these needles
are being placed. This should not alarm the patient since
this is usually only a fleeting sensation. The
anesthesiologist should be aware of this. The patient should
hold still during the entire procedure as this greatly
assists the physician in placement. Once the anesthetic has
been placed, the patient will feel warming of the bottom and
legs followed by loss of sensation of the involved area.
Then this is followed by a loss of strength. The time period
for this is anywhere from 5 to 25 minutes.
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Recovery
After
the procedure, you will be kept in bed with your head flat
for several hours to prevent you from developing a headache.
You will stay in bed until your legs are no longer numb and
it is considered safe for you to walk.
To
ensure a smooth recovery you should not drive or operate
machinery for at least 24 hours after having received
anesthesia. Also, avoid drinking alcohol for at least 24
hours after receiving anesthesia.
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Risks
Some
complications include bleeding disorders, prior bad or
allergic reactions to anesthetics, dehydration and immune
system disorders. Other possible risks to this procedure are
severe headache, drop in blood pressure, nerve damage,
infection, allergic reaction to the anesthetic used,
seizures and heart attack.
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Frequently Asked
Questions
Q: Is
the procedure painful?
A:
It is possible that needle
insertion for spinal anesthesia may be painful. The
operation (or contractions during childbirth) should not
cause pain after receiving spinal anesthesia, but you may still
feel pressure or tugging.
Q:
Will I be conscious during the surgery?
A:
The
patient will usually be sedated through IV medications
during the surgery and many times before placement of the
spinal anesthesia. It is possible to sedate the patient to
lessen the anxiety during the surgical procedure.
Q:
Will I have to stay flat for many hours after receiving spinal
anesthesia?
A: No, not usually. The use of smaller, sharper and
disposable needles makes is possible for you not to stay
flat. But you do need to stay in the bed until you fully
recover from the effects of spinal anesthesia and until you
have full strength back.
Q:
Is there a risk of paralysis or permanent damage?
A:
The
risk of paralysis is extremely low. The actual incidence of
neurologic dysfunction from bleeding complications is
estimated to be 1 in 220,000 for spinal anesthetics.
Q:
When is someone not an ideal candidate for spinal
anesthesia?
A:
The
patient may not be a candidate if he exhibits at least one
of the following characteristics:
-
allergic reaction to certain local anesthetics or
narcotics
-
has
disease of the nervous system
-
has a
bleeding tendency or coagulation disorder
-
has
an infection of the lower back area
-
has
had previous lower back surgery
-
has a
spinal deformity
-
is
morbidly obese (very overweight)
-
cannot cooperate or get into the proper position.
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