Preparing for Spinal Anesthesia Injection

Preparing for Spinal Anesthesia Injection

          Spinal anesthesia, also known as an epidural, is a procedure that involves injecting medication to numb specific lower body parts by using a small needle to inject the medication into the spinal canal. This causes numbness in the lower body area and is often used for surgeries in the lower body region such as the feet, knees, legs, hips, or lower abdominal region, including the intestines, uterus, and ovaries, as well as for childbirth.

However, in some cases, the patient may not be able to undergo an epidural due to various reasons such as:

• • Refusal
  • Abnormal blood clotting
  • Infections at the site of injection
  • Dehydration
  • High intracranial pressure
  • Pre-existing neurological conditions
  • Abnormal heart conditions
  • Severe hypertension.

In such cases, the anesthesiologist may use other forms of anesthesia, such as general anesthesia or inhalation sedation, to ensure the patient's comfort and safety during the procedure.

The advantages of a lumbar epidural are as follows:

       • It helps to relieve pain within 1-2 minutes.

       • Patients experience less back pain after surgery and are able to talk, respond, or report any abnormal symptoms during the operation.

       • Patients who are anxious or wish to sleep during surgery can communicate with the physician to receive anesthesia after the lumbar block has been performed and tested.

       • Pain medication can be managed by using a lower dose.

The disadvantages of a lumbar epidural are as follows:

       • Patients may experience nausea, vomiting, shaking, or itching.

       • They may not be able to move their legs for about 2-4 hours.

       • Urination may not occur in the first 12 hours after the block, but can be resolved by using a catheter.

       • Back pain is usually mild and responds well to pain medication.

       • The procedure may cause blood vessel dilation, leading to decreased blood pressure or slow heartbeat, which will be monitored by the physician throughout the surgery.

       • Breathing may become more difficult than normal.

       • Headaches may occur after surgery, and if a patient experiences them, they should inform their nurse or physician for proper assessment and treatment.

       • Weakness or numbness in muscles, or a loss of sensation in the back after the block wears off (12-24 hours after the procedure), will require a thorough neurological evaluation to prevent serious complications.

       • Infection may occur in the skin or in the spinal canal, but this is rare.

Procedures for the epidural:

      • The patient will be assessed and prepared, including signing the consent form.

      • In the case of non-urgent surgery, the patient should fast for at least 8 hours.

      • Fluid will be administered into the blood vessel.

      • Monitoring of the circulatory system will be conducted by measuring blood pressure, heart rate, oxygen saturation, and observing breathing and heart rhythm.

      • Patient positioning prior to the epidural needle insertion can be performed in either a lying down or sitting position. The anesthesiologist will instruct the patient to lie on their side, curl up, and tuck their chin to their chest, or sit hunched over with legs crossed. The back area will then be cleaned with an antiseptic solution and covered with a sterile cloth to prevent infection.

      • The anesthesiologist will palpate the back to locate the appropriate position for needle insertion. Once the needle is successfully inserted and in the correct position, medication will be injected to numb the area. The patient will be required to stay still as much as possible.

      • After the anesthesia is administered, the level of numbness will be evaluated to ensure the patient can tolerate the surgery without feeling pain. 

         Once the surgery is complete, the patient will receive postoperative care in a recovery room to monitor for potential complications or adverse reactions that may occur within at least an hour or until blood pressure and heart rate are stable for at least 30 minutes. It is recommended that the patient remain lying down for at least 6 hours.