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Updated 06 July 2016

Spinal and epidural anaesthesia – do you know the difference?

Modern anaesthetic techniques such as spinal and epidural anaesthesia make surgery less traumatic for many patients.

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Gone are the days when a general anaesthetic (GA) was your only option if undergoing surgery, a Caesarean delivery or a medical procedure. Nowadays, new modern anaesthesia techniques using regional anaesthesia have paved the way for other safe and effective alternatives.

Epidurals and spinals both involve injecting local anaesthetic between the vertebrae (the bones in your spine) to numb the body from the waist to the toes. While they work in different ways, they both enable patients to feel more in control during surgery while alleviating many of the complications associated with GA.

Read: Epidural and spinal anaesthesia

With people often not knowing the difference between spinal and epidural anaesthesia, the Royal College of Anaesthetists (RCOA) has compiled a series of patient guideline booklets. 

RCOA explains that a spinal anaesthetic is “a single injection with a thin needle that puts the local anaesthetic close to the nerves, within the fluid that surrounds the spinal cord".

Read: Spinal anaesthesia risks

“With an epidural, a fine plastic tube (an epidural catheter) is threaded through a needle and local anaesthetic is injected down the tube, which is left in the epidural space in a patient’s back.”

Complications of regional anaesthetics

Modern anaesthetic techniques are generally very safe, but all anaesthesia carries a risk of possible side effects or complications. Fortunately, most of the following common side effects associated with spinal blocks and epidurals don’t last long and can usually be treated effectively and quickly.

  • Nausea, vomiting
  • Itching and shivering
  • Drop in blood pressure, causing dizziness or light-headedness
  • Headache
  • Backache, pain  and/or bruising at injection site
  • Temporary problems in passing urine, which can be resolved by inserting a catheter.

Note: Recommend including this excellent animated reference video with mini article 1a above (Difference Between Epidural and Spinal Techniques)

 Speaking to your anaesthetist about regional anaesthesia

  • Get informed and don’t be afraid to ask questions! Make sure your anaesthetist has comprehensive experience of the regional anaesthetic technique you are considering.  
  • Your anaesthetist should enquire about your medical history and any medical conditions like heart or lung illnesses. He should also explain the process, benefits and possible complications of spinals and epidurals so you can decide together which will be the most suitable.
  • Smoking, dehydration, having a bleeding/ immune system disorder and whether you’ve experienced previous adverse effects with any type of sedation or anaesthesia may increase your risk of complications.
  • Make sure to tell your doctor/anaesthetist about all prescription and over-the-counter (OTC) medications you are taking and whether you have any drug/other allergies.
  • Discuss with your anaesthetist beforehand whether you prefer being completely awake or sedated to reduce awareness/anxiety. 
  • Regional anaesthesia is not suitable for everyone. If your anaesthetist is unable to perform a spinal, regional anaesthesia doesn’t work completely or the surgery is more complicated than anticipated, you’ll need a full GA.

Read more:

Questions and answers about epidural analgesia

Maintaining anaesthesia

Anaesthesia technique affects breast cancer outcome

Sources:

http://www.rcoa.ac.uk/system/files/PI-ACHKR-COL-2014.pdf

http://www.royalberkshire.nhs.uk/patient-information-leaflets/Anaesthetics/Anaesthetics_spinals-and-epidurals.htm

http://www.rcoa.ac.uk/document-store/your-spinal-anaesthetic

http://www.nhs.uk/Conditions/Epidural-anaesthesia/Pages/Whatitisusedfor.aspx

 
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