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Spinal and Epidural Anesthesia


Why is this procedure done?


Both of these kinds of anesthesia are drugs that are given to numb parts of your body to block pain. You are awake for each of them. Doctors, nurses, or other staff with special training may give you these drugs. They will stay with you and watch you closely during your surgery. You may also get other drugs to help you stay calm during your procedure. � �
Spinal anesthesia: This is also called a "spinal. " � It is used if you are going to have surgery on your legs or pelvis. Sometimes, it is used during childbirth. Women may have a spinal if they are going to have a cesarean section. If you have a spinal, you will be numb from your chest to your toes. You will also not be able to move this area while the drugs are in effect. � �
Epidural anesthesia: This is also called an "epidural. " � You may have an epidural in your low back or in your mid back. It depends on where your surgery is. With an epidural, a small tube is placed in the back. Drugs are given through this tube. Your belly and lower body become numb and you will not feel pain. You may be able to move your legs a little after an epidural. � �
Combined spinal/epidural: Sometimes, after a spinal is done, an epidural will be also placed in the back. This is a combined spinal/epidural. The epidural will let you get drugs in your back after surgery. You may need less pain shots or pain pills if you have an epidural. � �

What will the results be?


You will be awake and feel no pain during your surgery. You may recover much faster after the spinal or epidural than from general anesthesia (being put fully to sleep). You may be given some drugs in your I.V. to calm you along with the spinal or epidural during your surgery or after your delivery. � �

What happens before the procedure?


Your doctor will take your history. Talk to the doctor about: � �
  • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
  • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin � �, ibuprofen, Aleve � � (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
  • Pregnancy or possible pregnancy

What happens during the procedure?


  • Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids. You may have a tube in your bladder to drain urine.
  • The staff will clean a small area on your back. You will get a numbing drug in the part where you will have the anesthesia. This part stings a bit, but it makes it less painful when the spinal needle is put in your back. You will hold your back in a certain way. This makes it simpler for the doctor or care provider to place the spinal needle in your back.
  • Spinal anesthesia: Your doctor will give you one dose of the drug. It is placed directly in the fluid around the area of your spinal cord. The drug will take effect right away. It works well for surgeries from the waist to the toes.
  • Epidural anesthesia: Your doctor will give you the first dose of the drug. It is given in the space around the area of your spinal cord. The drug will take effect within 10 to 20 minutes. If you need more than one dose, they will put a small tube in your back and leave it in place. You may then get more drugs through this tube to help with your pain. Special bandages are placed over the tube in your back. This is to lower the chance of infection while the tube is in.
  • Giving these types of anesthesia most often takes about 15 minutes.

What happens after the procedure?


  • After you have a spinal or epidural, you may go on to have a procedure.
  • You will go to the Recovery Room after surgery.
  • You may feel tired or dizzy after surgery.
  • Spinal anesthesia: You will need to stay in bed until it wears off and you are able to move your legs.
  • Epidural anesthesia: The tube will be taken out of your back when it is not needed to help with your pain. You have to lie in bed until you are strong enough to walk.

What care is needed at home?


For the first day after your surgery: � �
  • Do not drive or run machinery.
  • Do not drink beer, wine, and mixed drinks (alcohol).

What follow-up care is needed?


Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits. � �

What problems could happen?


  • Bad headache
  • Signs of low blood pressure like dizziness or fainting
  • Nerve damage
  • Infection from the spinal needle
  • Allergy to the anesthesia used

Where can I learn more?


Journal of the American Medical Association � �
http://jama.ama-assn.org/content/306/7/781.full.pdf � �

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. � �

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