Journal of Perioperative Medicine
Open Access

An Overview on Spinal Anaesthesia

Hinnerk Wulf^{* *}Correspondence: Hinnerk Wulf, Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Germany, Email:

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Description

Spinal anesthesia, also known as subarachnoid anesthesia, is a regional anesthesia technique that involves the injection of a local anesthetic drug into the subarachnoid space, which surrounds the spinal cord. The anesthetic agent produces a reversible block of nerve impulses, resulting in loss of sensation and motor function in the areas innervated by the spinal nerves below the level of injection. Spinal anesthesia has been used for over a century for surgical and diagnostic procedures, and it is still a commonly used anesthesia technique today. In this commentary, we will explore the benefits and risks of spinal anesthesia, its indications and contraindications, and the different types of local anesthetic agents used in spinal anesthesia.

One of the main advantages of spinal anesthesia is that it produces a fast and profound block, which allows for rapid onset of anesthesia and surgery. The anesthetic effect begins within a few minutes of injection, and the duration of the block can be extended by the addition of opioids or other adjuncts to the local anesthetic. Spinal anesthesia can also provide a more extensive and profound block than other regional anesthesia techniques such as epidural anesthesia, which may be beneficial for certain procedures or patients.

Spinal anesthesia is a relatively safe technique, with a low incidence of serious complications. However, like any medical procedure, it is not without risks. The most common adverse effects of spinal anesthesia are hypotension (low blood pressure), bradycardia (slow heart rate), and nausea and vomiting. Hypotension occurs because the anesthetic agent blocks the sympathetic nervous system, which regulates blood pressure and heart rate.

Other potential risks of spinal anesthesia include headache, backache, and nerve damage. Post-dural puncture headache is a common complication that occurs when the needle used to inject the anesthetic punctures the dura mater, the outermost layer of the spinal cord. The resulting leak of cerebrospinal fluid can cause a headache that is usually relieved by lying down. Backache may also occur due to the injection of the anesthetic into the spinal canal. Nerve damage is a rare but serious complication that may occur if the needle or anesthetic damages the spinal cord or nerves.

Spinal anesthesia is indicated for a wide range of surgical and diagnostic procedures, including lower limb surgery, urological procedures, cesarean section, and diagnostic lumbar puncture. It is also commonly used for pain management in labor and delivery. Spinal anesthesia is contraindicated in patients with severe coagulopathy (bleeding disorders), infection at the injection site, and allergy to local anesthetic agents. It should also be used with caution in patients with hypovolemia (low blood volume), cardiac disease, and neurologic disease.

The choice of local anesthetic agent used in spinal anesthesia depends on several factors, including the desired onset and duration of anesthesia, the patient's medical history, and the surgeon's preference. The most commonly used local anesthetic agents for spinal anesthesia are bupivacaine, ropivacaine, and lidocaine. Bupivacaine is a long-acting local anesthetic that provides a prolonged block and is often used for surgical procedures.