Spinal Anaesthetic

What is a spinal?

A local anaesthetic drug is injected through a needle into the small of your back to numb the nerves from the waist down to the toes for two or three hours.

How is the spinal preformed?

1. Your anaesthetist will discuss the procedure with you before on the ward.

2. You will meet the anaesthetist assistant who will stay with you during your time in theatre.

3. A needle will be used to insert a small plastic tube (a cannula) into your vein in you hand or arm and then the staff looking after you will help you into the correct position for the spinal.

4. You will either sit on the side of the bed with your feet on a low stool or lie on your side, curled up with your knees tucked up towards your chest. In either case the staff will support and reassure you during the injection.

5. The anaesthetist will explain what's happen thoughout the process so that you are aware what is happening "behind your back".

6. As the spinal begins to take effect, your anaesthist will measure the process and take it's effectiveness.

7. Your anaesthetist will will give you the spinal injection and stay with you thoughout the procedure.

What will I feel?

Usually, a spinal should cause you no unpleasant feelings and should take only a few minutes to preform.

- As the injection is made you may feel pins and needles in one of your legs - if you do, try to remain still and and tell your anaesthist about it.

- When the injection is finished you normally lie flat as the spinal works quickly and is usually and is usually effective within 5-10 minutes.

- To start with, the skin will feel numb to touch and the leg mucles are weak.

- When the injection is working fully you will be unable tomoveyour legs or feel any pain below the waist.

-During the operation you maybe given oxygen to breathe via a lightweight, clear plastic mask to improve the levels in your blood.

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Only when both you and your anaesthist is completely happy that the anaesthetic has worked will you be prepared for the operation.

Why have a spinal?

Advantages, there may be;

Reduced blood loss during the surgery/ less need for a blood transfusion.

- Less risk of blood clots forming in the leg veins(deep vein thrombosis, DVT)

- Less risk of chest infections after surgery

- Less effect on heart and lungs

- Excellent pain relief immediatly after surgery

- Less need for strong pain relieving drugs

- Less sickness and vomiting

- Earlier return to drinking and eating after surgery

- Less confusion after the operation in older people

With a spinal, you can communicate with the anaesthist and surgeon before, during and after surgery. If an operating camera is being used, you may even be able to watch the operation on on television if you wish!

Alernatively, you may decide you wish to have sedation while the operation is in progress.

Opperations a spinal commonly/ often used for:

- Orthopeadic surgery - any major operation on the leg bones or joints.

- General surgery - hernia repair, varicose veins, piless (haemorrhoids).

- Vascular surgery - repairs to the blood vessels of the leg

- Gynaecology - Vaginal repairs or operations on the bladder outlet.

- Urology - prostateremoval, bladder operations and genital surgery.

However, you may still need general anaesthetic if:

- Your anaesthetist cannot preform the spinal satisfactorily

- The spinal does not work satisfactorily

- The surgery is more complicated than expected

Side effects and complications

As well all anaesthetic techniques there is a possiblity of unwanted side effects or complications.

Very common and coomon side effects

These may be unpleasant, but are easily treated and do not last long.

- Headache - When the spinal wears off and you begin to move around there is a risk of developing a headache.

- Low blood pressure - As the spinal takes effect, it can lower your blood pressure and make you feel faint or sick. This can be controlled with the fluids given by the drip and by giving you drugs to raise your blood pressure.

- Itching - This can occur as a side effect of using morphine- like drugs in combination with local anaesthetic drugs in spinal anaesthesia. If you experience itching it can be treated, as long as you tell the staff when it occurs.

- Difficulty passing water (urinary retention) - You may find it difficult to empty your bladder normally for as long as the spinal lasts. Your bladder function returns to normal after the spinal wears of. You may require a catheter to be placced in your bladder temporarily, either while the spinal wears off or as part of the procedure.

- Pain during the injection - As previously mentioned, you should immediatly tell your anaesthetist if you feel and pain or pins and needles in your leg or bottom as this may indicate irritation or damage to a nerve and the needle will need to be repositioned.

Rare complications

Nerve damage - this is a rare complication of spinal anaesthesia. Temporary loss of sensation, pins and needles and sometimes muscle weakness may last for a few days or even weeks but almost all of these will make a full recovery in time. Permanent nerve damage is even more rare and has about the same chance of occuring as major complications of general anaesthesia.

After your spinal

- Your nurses will make sure that the numb area is protected from pressure and injury until sensation returns.

- It takes 1.5 to four hours feeling (sensation) to return to the area of your body that is numb. You should tell ward staff about any concerns or worries you may have.

- As sensation returns you may experience some tingling in the skin as the spinal wears off. At this point you may become of some of the pain from the operation site and youshould ask for more pain relief before the pain becomes too obvious.

- As the spinal anaesthetic wears off, please ask for help when you first get out of bed.

- You can normally drink fluid within an hour of the operation and may be able to eat a light diet.

Useful Organisations

The royal college of anesthetists

Website: www.rcoa.ac.uk

E-mail: info@roca.ac.uk

This organisation is responsible for standard in anaesthesia, critical care and pain management throughout the UK.

The European Society of Regional Anaesthesia andPain Therapy

Website: www.esraeurope.org

This organisation works to further regional anaesthesia in Europe.

Thank you for reading x