Spinal and epidural anesthesia - Overview

Alternative Names

Intraspinal anesthesia; Subarachnoid anesthesia; Epidural; Epidural block; Peridural anesthesia

Definition of Spinal and epidural anesthesia:

Spinal and epidural anesthesia are medicines that numb parts of your body to block pain. They are given through shots in or around the spine. You will stay awake during both of these types of anesthesia.

Description:

The area of your back where the needle will be inserted will be cleaned with a special solution. Most of the time this shot will go in your lower back. This area may also be numbed with a local anesthetic. You may receive fluids through an intravenous line (IV, in a vein). You may also get medicine to help you relax.

For an epidural:

The doctor will inject medicine just outside of the sac of fluid around your spinal cord. This is called the epidural space.
The medicine numbs, or blocks feeling in a certain part of your body so that you cannot feel pain. The medicine begins to take effect in about 10 to 20 minutes. It works well for longer procedures. Women often have epidurals during childbirth.
A small tube (catheter) is often left in place. You can receive more medicine through the catheter to help control your pain during or after your procedure.

For a spinal:

The anesthesiologist will inject medicine into the fluid in your spinal cord. This is usually done only once, so you will not need to have a catheter placed.
The medicine begins to take effect right away. It works well for shorter and simpler procedures.

Oxygen levels in your blood, your pulse, and your blood pressure will be checked during your procedure. You will have a bandage where the needle was inserted.

Why the Procedure Is Performed:

Spinal and epidural anesthesia have fewer side effects and risks than general anesthesia (asleep and pain-free). Patients usually recover much faster and can go home sooner.

Spinal anesthesia is often used for genital, urinary tract, or lower body procedures.

Epidural anesthesia is often used during labor and delivery, and surgery in the pelvis and legs.

Epidural and spinal anesthesia are often used when:

The procedure or labor is too painful without any pain medicine.
The procedure is in the belly, legs, or feet.
Your body can remain in a comfortable position during your procedure.
You want fewer side effects and a shorter recovery than you would have from general anesthesia.

Reviewed last on: 3/28/2011
Scott Miller, MD,Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Sherwood ER, Williams CG, Prough DS. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 18.

Hawkins JL, Arens JF, Bucklin BA, et al. Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. April 2007;106(4).

Gerges FJ, Kanazi GE, Jabbour-khoury SI. Anesthesia for laparoscopy: a review. Journal of Clinical Anesthesia. Feb 2006;18(1).

Reynolds F. Neurological Infections After Neuraxial Anesthesia. Anesthesiology Clinics. March 2008;26(1).

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