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St-Elisabeth site - Uccle
02-614 20 00
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02-614 30 00
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02-614 42 00
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Locoregional anaesthesia

Locoregional anaesthesia: spinal anaesthesia

WHAT IS SPINAL ANAESTHESIA?

Spinal anaesthesia is a locoregional anaesthesia technique that is commonly used in surgery.

This technique is a close “relative” of epidural anaesthesia, but easier to perform as it does not require the installation of a catheter. Contrary to an epidural, spinal anaesthesia is the process of injecting a local anaesthetic directly into the cerebrospinal fluid, which is the fluid surrounding the spinal cord, in the space between two vertebrae of the vertebral column.

With this type of technique, a very reliable and efficient anaesthesia of the lower part of the torso and the lower limbs can be achieved.

HOW IS SPINAL ANAESTHESIA PERFORMED?

The blood pressure, heart rate and pulse of the patient are monitored.
The technique can be performed in a sitting position, or with the patient lying on his/her side. When the back is disinfected, the anaesthetist performs a local anaesthesia of the skin, before proceeding with the spinal anaesthesia. A very fine needle is used, with a tip that does not cause any damage to skin tissues.

The injection is performed between two lumbar vertebrae, at the very bottom of the vertebral column, just below the end of the spinal cord.

DO I HAVE TO REMAIN FULLY AWAKE?

A procedure conducted under spinal anaesthesia does not necessarily mean that the patient has to remain conscious throughout the operation. Obviously, we can also offer sedation to complement the spinal anaesthesia, when the patient wants to remain drowsy or sleep during the operation, for his/her comfort or because he/she is experiencing some anxiety. Therefore, sedation is frequently combined with locoregional anaesthesia to improve comfort during surgical operations.

WHAT ARE THE ADVANTAGES, THE SIDE EFFECTS AND THE COMPLICATIONS?

Advantages

  • Reduced pain in the wake of the procedure

  • The consequences of a general anaesthesia after the operation (nausea, vomiting, drowsiness...) are reduced

  • The problems caused by tracheal intubation (sore throat, broken teeth...) are reduced

  • Quicker recovery of eating and drinking abilities after the procedure

  • Possibility of taking part in the operation

  • Reduced occurrence of cerebral troubles among elderly patients (confusion, disorientation...)

  • Reduced mortality and fewer severe post-operative complications compared with general anaesthesia.

Common and benign side effects

  • Lowered blood pressure
  • Slower heart rate
  • Itching
  • Headaches ( < 1%)

Severe but very rare complications

  • Allergy to local anaesthetics
  • Neurological complications (neurological deficiency after the procedure)
  • Infectious complications (meningitis, medullary abscess).

WHAT ARE THE CONTRAINDICATIONS OF SPINAL ANAESTHESIA?

  • Patient refusal
  • Blood clotting disorders
  • Poor skin state at the puncture point (infection, tattoo, birthmark)
  • Medullary pathology
  • Severe infection
  • Allergy to local anaesthetics

GOOD TO KNOW

  1. A history of spinal disc herniation is not a contraindication
  2. The effect of spinal anaesthesia is near instantaneous
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