Spinal and epidural anesthesia

Definition

Spinal and epidural anesthesia are procedures that deliver medicines that numb parts of your body to block pain. They are given through shots in or around the spine.

Alternative Names

Intrathecal anesthesia; Subarachnoid anesthesia; Epidural

Description

A doctor who gives you epidural or spinal anesthesia is called an anesthesiologist. In some situations, this may be administered by a certified registered nurse anesthetist..

First, the area of your back where the needle is inserted is cleaned with a special solution. The area may also be numbed with a local anesthetic.

You'll likely receive fluids through an intravenous line (IV) in a vein. You may receive medicine through the IV to help you relax.

For an epidural:

For a spinal:

Your pulse, blood pressure, and oxygen level in your blood are checked during the procedure. After the procedure, you will have a bandage where the needle was inserted.

Why the Procedure Is Performed

Spinal and epidural anesthesia work well for certain procedures and do not require placing a breathing tube into the windpipe (trachea). People usually recover their senses much faster. Sometimes, they have to wait for the anesthetic to wear off so they can walk or urinate.

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:

Risks

Spinal and epidural anesthesia are generally safe. Ask your doctor about these possible complications:

Before the Procedure

Tell your provider:

During the days before the procedure:

On the day of the procedure:

After the Procedure

After either type of anesthesia:

The nurse may ask you to try to urinate. This is to make sure your bladder muscles are working. Anesthesia relaxes the bladder muscles, making it hard to urinate. This can lead to a bladder infection.

Outlook (Prognosis)

Most people feel no pain during spinal and epidural anesthesia and recover fully.

References

Hernandez A, Sherwood ER. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. St Louis, MO: Elsevier; 2022:chap 14.

Macfarlane AJR, Hewson DW, Brull R. Spinal, epidural, and caudal anesthesia. In: Pardo MC, ed. Miller's Basics of Anesthesia. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 17.


Review Date: 4/1/2023
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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