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Spinal and Epidural Anesthesia

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ID: ANCE00195
MEDICAL ANIMATION TRANSCRIPT: If you are having certain operations, such as pelvic, hip, or leg surgery, you may be able to avoid general anesthesia by having your operation under spinal or epidural anesthesia instead. Spinal and epidural anesthesia are also often used during childbirth. Both spinal and epidural anesthesia involve injecting medications near the spinal cord. This makes you numb from the level of your chest down to your feet. Advantages of spinal and epidural anesthesia include the ability to be awake during the operation and to avoid the risks associated with general anesthesia. Because spinal and epidural anesthesia rarely cause decreases in blood pressure and other changes that might require rapid treatment, you will have an intravenous line in place so that fluids or medicines can be administered quickly. You will also be connected to various monitors to keep track of your blood pressure, pulse, and oxygen content of your blood. Prior to receiving spinal or epidural anesthesia, the anesthetist will use an antiseptic solution to clean the area of your back where the medicine is injected. To decrease pain from the needle stick, he or she may instill a local anesthetic directly over the spot where the spinal or epidural needle will be inserted. Spinal anesthesia involves a single injection of medication into the sac of fluid that surrounds your spinal cord. To reach this fluid sac, the anesthetist will pass a needle through your skin, between the vertebral bones, and, finally, through spinal ligaments and the dura, which is the protective membrane around your spinal cord. Spinal anesthesia begins working almost immediately after the injection is completed. With epidural anesthesia, the needle does not penetrate the dura, and medication is deposited just outside of the sac of fluid that surrounds your spinal cord. Epidural anesthesia may be given in a single dose, or the anesthetist may leave a tiny flexible tube or catheter in place in the event more aesthetic is required. During a longer-than-expected procedure, epidural anesthesia takes about 10 minutes to begin working. After the injection of spinal anesthesia or the removal of an epidural catheter, a small bandage will be placed over the area where the needle was inserted. After spinal anesthesia, you will be kept in bed with your head flat for several hours.

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