Spinal Anaesthesia 1. What is Spinal Anaesthesia? Spinal Anaesthesia is a type of regional anaesthesia for surgeries below the umbilicus. A very thin needle is inserted between the vertebrae, through the dura, and into the fluid-filled subarachnoid space. A small amount of local anaesthetic drug is injected into the fluid to numb the nerves from the waist down to the toes for a period of 4-6 hours. To receive the Spinal Anaesthesia you will be either asked to sit on the side of the bed or curls up with your legs tuck up towards your chest. You will remain conscious but feel no pain. Your legs will feel heavy. At times you may feel sensations of movement or pressure during your surgery. 2. Spinal Anaesthesia or General Anaesthesia. Which is better? There are some advantages with Spinal Anaesthesia: It avoids the ill effects of General Anaesthesia such as sore throat, teeth, lips and gums injury, and chest infection. 1. It helps to reduce incidence of blood clots in the legs. 2. There may be less blood loss during some surgeries. 3. You in full control of your breathing during the surgery. 4. Better pain control in first few hours following surgery. 5. T here is generally less sickness and drowsiness after surgery. 6. You are able to eat and drink sooner after surgery. 7. You are able to communicate with the Anaesthesiologist and Surgeon during surgery. In fact General or Spinal Anaesthesia has its own ill effects and risks. Your Anaesthesiologist will suggest the mode of Anaesthesia after considering your medical condition and type of surgery. 3. What ill effects may occur in Spinal Anaesthesia? You may experience pain during the injection. If you feel pain in your legs or buttock, you must tell your Anaesthesiologist immediately and the needle will need to be repositioned. It must be stressed that you may still require General Anaesthesia if: There are difficulties performing the Spinal The spinal does not work satisfactorily The surgery turns out to be more complicated or prolonged than initially anticipated Low blood pressure with associated faintness and sickness. Itching due to morphine-like drugs used in combination with the local anaesthetic Headache once the spinal has worn off. Problems passing water (urinary retention) - bladder function returns to normal only when the spinal anaesthetic has completely worn off and during this time it may be necessary for the patient to have a catheter placed into the bladder temporarily. Following Spinal Anaesthesia the nurses looking after the patient will ensure the numb areas ( buttock and legs) are protected from injury and excess pressure until normal sensation returns. As the spinal wears off you may experience tingling in the skin and discomfort from the operative site. At this point you can ask for more pain relief medications. Other serious but rare complications such as cardiac arrest, broken needle, infection, bleeding resulting in hematoma, with or without subsequent neurological sequelae due to compression of the spinal nerves. 4. Under what conditions "Spinal Anaesthesia" is not suitable? Local infection or sepsis at the site of injection, bleeding disorders, low blood pressure, space occupying lesions in the brain, and disorders of the spine. 5. Will Spinal Anaesthesia causes low back pain ? Low back pain is among the most common symptoms experienced in adults. Studies have shown that Spinal Anaesthesia not increase the incidence of low back pain development afterwards.