Dorsal anesthesia: anesthesia in the spine

Spinal anesthesia, contraindications, reviews

Spinal anesthesia, it is also spinal or in common speech, dorsal anesthesia, which is placed in the back and is often confused with epidural anesthesia.

Spinal anesthesia is a kind of local anesthetic, when the procedure occurs by blocking the transmission of signals from the area of ​​origin painful sensations at the level of the spinal roots, during which they can not transmit a nervous pain impulse to the spinal cord, by which they will go to brain.

What is the difference between spinal anesthesia and epidural

Epidural and spinal anesthesia are very similar, the difference is only in the depth of the injection of anesthetic.

In the case of epidural, the drug is injected into the upper cerebrospinal membrane, filled with blood vessels and fatty deposits, and spinal form uses a longer needle that brings the drug to the space that directly surrounds the trunk of the spinal cord. The choice of this or that method depends on the area to be anesthetized, since at each level of the spinal cord and its membranes there are nerve roots responsible for different areas of the body. In addition, it can be noted that spinal anesthesia retains more sensitivity when the patient feels everything, but it does not hurt, and also acts more quickly.

How is analgesia performed?

• For spinal anesthesia apply only local anesthetics that do not affect the patient's consciousness, as well as a long and thin needle that can get close to the center of the spinal cord.
• The procedure for insertion of the needle is carried out when the patient sits or lies on his side, while he should not move or breathe so as not to get a spinal cord injury.
• The needle is inserted into the back directly into the spine approximately at the level of the navel or lower, since in this case the risk of damaging brittle brain structures is minimal.
• An inexperienced doctor may not get into the spinal cord for the first time, but to rest on the vertebra, it is also not painful or scary, but simply requires a correction of the direction.
• The needle entry into the subarachnoid space (the middle cerebral cortex, in the Russian language called the cobwebby one, along which moves the cerebrospinal fluid) must confirm the free outflow of the CSF, for which the needle opened from the outside rotates around its axis.
• Then the needle connects to the syringe and anesthesia is induced.
• The needle is carefully removed.

What the patient feels with spinal anesthesia

• The introduction of a needle for the patient is absolutely painless, but he can feel the doctor's hands touching the body and the very entrance of the needle, and also hear the characteristic sound of her passage through the cartilaginous tissue. At the same time nothing pricks and does not pluck.
• Complete anesthesia occurs in the interval from twenty to forty minutes, and the duration of anesthesia depends on the type of anesthetic.
• With proper anesthesia, the patient is conscious, feels well, partially feels the manipulation of the surgeons as tactile touches that do not deliver pain.
• Anesthesia occurs throughout the body below the level of the injection.
• Sometimes there is a tremor in the whole body of the patient at some stages, which can reach such a degree that the body begins to bounce on the operating table, this is a normal individual reaction.

What drugs are used

Name of the drug:	After how many minutes the effect comes:	Duration of anesthesia (min.):
Lidocaine	5	45-90
Bulivacaine	5-8	90-240
Ropivacaine	10-20	120-360

Self-preparation of the patient

• To prevent unpleasant consequences before surgery with spinal anesthesia, the following rules should be observed:
• Refuse to eat at least six hours before the minute of X.
• Beforehand remove all prostheses and inform the surgeon about the presence of non-removable prostheses.
• Remove all ornaments, remove make-up, take a shower, cross the cross on the lace instead of the chain.
• Make a list of all performed operations and medications for which there is intolerance or other individual reactions.

Advantages of the method and why it is used

• Spinal anesthesia is considered one of the safest methods of anesthesia, along with epidural, which is practically a twin brother, since it does not affect the human body and nervous system as a whole.
• The risk of developing an anaphylactic shock is also minimal, or there is no likelihood that the patient will not leave anesthesia.
• The injected anesthetic is not transmitted to the blood, and, therefore, there is no likelihood of harm to the child if the anesthesia is injected into the pregnant.
• The patient is in sound mind and memory, and therefore, freely communicating with the surgeon, to comment on his condition and sensations.

Proceeding from the above advantages, this kind of anesthesia is used in the following cases:

• To anesthetize surgical interventions below the level of the navel, which may include gynecological surgery, urological, foot surgery.
• For anesthesia people with an increased risk of negative outcomes, for example, elderly, hypertensive or allergic people, people with contraindications to general anesthesia.
• In the case of caesarean section, since the anesthetic does not affect the child in an euphoric way, and, therefore, not harms him and allows him to take the first breath himself, which has a beneficial effect on the disclosure lungs. Also after spinal anesthesia, the analgesic drug does not penetrate into the milk.

Possible complications of spinal anesthesia

Despite the fact that spinal anesthesia is one of the safest varieties of anesthesia, it still has its risks:

• If the anesthetist exceeds the dose of the drug, then it can simultaneously freeze the respiratory muscles, which will require artificial ventilation of the lungs for the duration of its action.
• This procedure provokes a fairly strong reduction in pressure, which requires constant monitoring during the entire duration of the drug with the use of resuscitation procedures, if necessary. Cardiac arrest is extremely rare, but to stimulate many patients put adrenolino containing a dropper.
• Due to the fact that the patient does not feel his lower limbs for a long time, he may develop symptoms of a long positional squeezing, and, more simply, you can accidentally strongly restrain or squeeze a limb or even squeeze circulation.
• Allergic reactions.

Who should not carry out such anesthesia

• Spinal anesthesia is not performed for patients who have signed a fundamental rejection of it.
• Absence of resuscitation facilities for safety is a mandatory contraindication to the procedure.
• Patients with severe dehydration.
• Patients suffering from high blood coagulability.
• Urgency of surgical intervention, which does not allow waiting half an hour.
• When sepsis, the infection does not hit with blood in the dorsal, and through it into the brain.
• Infections of the skin at the site of injection of the needle or herpes for the same reason.
• At the birth of a dead child or child with severe hypoxia.
• Allergies to the use of a local anesthetic.
• Some diseases of the central nervous system.
• Increased craniocerebral pressure, since the introduction of additional fluid into the cerebrospinal fluid aggravates the situation
• Low blood pressure and some cardiovascular pathologies.

Who should be treated with caution

• With deformation or strong curvature of the spine.
• If the patient has previously had spinal injuries.
• With mental or emotional problems in the patient, as during the operation, he can behave inadequately or will be unable to calmly rest for the time of the injection of the anesthetic and the needle.
• Children - for the same reason, and also not to traumatize the child psychologically.
• If there is a risk of great blood loss.
• Feverish conditions that can be a symptom of an infection in the blood.
• Cardiovascular pathology.
• Neurological diseases.

Reviews

The patients' comments to whom the operation was performed are noted mainly by the fear of the forthcoming procedure, the difficulty of maintaining a fixed position during the insertion of the needle during fights, and also unpleasant sensations at the injection site for a long time that occur after a short time after the operation, they are difficult to call pain, and mostly appear during the shift weather. Sometimes there was nausea, severe tremor and a decrease in pressure., Which is the norm.

A source: http://NashiNervy.ru/o-nervnoj-sisteme/osobennosti-spinnomozgovoj-anestezii.html

Spinal anesthesia

The most commonly used technique for regional anesthesia in modern anesthetic practice is spinal anesthesia.

This technique combines a persistent anesthetic effect, a low percentage of complications, the ability to eliminate postoperative pain and all this along with technical simplicity.

With spinal anesthesia, the nerves that conduct pain for some time are turned off in certain areas.

To do this, an anesthetic drug is injected at a specific location in the spine near these nerves.

Preparations, local anesthetics, while they will be introduced into the subarachnoid (spinal) space.

The spinal space is in the spinal canal and protected from all sides by the spine. It starts from the large occipital foramen in the skull and ends at the level II of the sacral vertebra (S2).

Inside the space there are clinically important structures of the nervous system - the spinal cord and its continuation in the form of a horse's tail, as well as cerebrospinal fluid or in another way - the cerebrospinal fluid.

Spinal injection of the anesthetic is performed at level II of the lumbar vertebra (L2) or lower (L3-L4), and the spinal cord of the adult person ends at level I of the lumbar vertebra (L1), accordingly the risk of damage to the spinal cord is reduced to zero.

What is the difference between spinal anesthesia and epidural?

• Anatomic location. The spinal space is located more deeply in the spine. In it are located the spinal cord and the cerebrospinal fluid, and in the epidural space the fat and connective tissue.

• Spinal anesthesia is performed only below I of the lumbar vertebra (L1), so as not to damage the dorsal the brain, when both epidural anesthesia can be performed not only in the lumbar, but also in the thoracic department. This is due to the anatomical features of the location of the epidural space. It is closer to the spine, and there is no spinal cord in it.

• Technique and sterile styling for manipulation are different. The epidural set has a thick needle and a long catheter, which is later attached to the chest, and with spinal anesthesia using thin needles, without catheters.

• Another difference from epidural anesthesia is the possibility of more complex surgical interventions.

With spinal anesthesia, all types of sensitivity (pain, temperature, motor and etc.), when, during epidural anesthesia, preference is given only to the painful sensitivity.

• Time of onset of the effect with spinal anesthesia is 5-15 minutes, and with epidural 10-30 minutes.

What is the difference between spinal anesthesia and general anesthesia (anesthesia)?

• With general anesthesia, the patient is immersed in drug-induced sleep with reversible loss of various types of sensitivities, whereas spinal anesthesia reversible loss of sensitivity occurs only at the level of spinal roots and the patient is in full consciousness.

• Spinal anesthesia is designed for operative interventions on the lower limbs, pelvic organs and the lower floor of the abdominal cavity. Conducting general anesthesia has more extensive indications for surgical interventions.

If the patient is given a choice, then rather spinal anesthesia should be preferred, as a safer, rather than general anesthetic.

Indications for spinal anesthesia:

• Operations on the lower limbs.

These include amputations of varying complexity, phlebectomy (vein removal), plastic surgery, phlegmon opening (diffuse purulent inflammation of tissues), prosthetics of arteries, operations on the knee joint, external fixation by the device of the CCP (a set of combined injury).

• Operations on pelvic organs.

These are urological operations in the form of transurethral resection of the prostate (TURP), varicocele (varicose veins spermatic cord and testicles), open access, hydrocele (edema of the testicles), plastic of the external genital organs, hemorrhoidectomy.

• Operations on the lower floor of the abdominal cavity. They include hernia repair, appendectomy open access, caesarean section.

Before the forthcoming surgical intervention with the patient, an anesthesiologist-resuscitator doctor talks.

He collects an anamnesis, fills in the medical documentation, takes from the patient written voluntary consent, and also tells about what contraindications exist and possible complications of anesthesia benefits.

Contraindications to spinal anesthesia:

Absolute:

• Failure of the patient to perform anesthesia • Allergy to local anesthetics • Infection at the site of the proposed puncture • Infectious diseases in the acute stage.

• Intracranial hypertension.

Relative:

• Reduced circulating blood volume (hypovolemia) • Changed parameters of the coagulating system of blood (coagulopathy).

• Chronic back pain.

Preoperative preparation of the patient

On the eve of the operation, the last meal of food and liquid should be no later than 2 hours before the upcoming sleep.

In the morning before the operation, the patient does not eat anything and does not drink. Removes all jewelry (rings, earrings, chains, eyeglasses, watches, etc.), removable dentures and waits in the ward until the medical personnel come for him.

The obligatory final stage for the forthcoming anesthesia and surgery is premedication - appointment sedative drugs in order to stabilize the patient's psycho-emotional background, relieve stress, tremor and fear.

After the preparation for the operation, compliance with all requirements, morning premedication, the patient, lying on a gurney, accompanied by medical personnel is fed into the operating unit.

In the operating room, the patient is shifted from the wheelchair to the operating table. There he is waiting for an anesthesia team consisting of a doctor and anesthesia nurse.

Mandatory, the first manipulation, with which everything begins - is the acquisition of vascular (venous) access. This manipulation consists in percutaneous insertion of a sterile vascular catheter into a vein.

Further, this catheter is fixed and a system for intravenous infusions with physiological sodium chloride solution is connected to it. Manipulation is necessary in order to have constant access for the introduction of drugs intravenously.

In order to avoid a possible reduction in blood pressure during anesthesia, the volume of the infusion load should be at least 1000 ml.

After that, a cuff is connected to the patient for changing blood pressure and electrode sensors are attached to the chest for the permanent recording of an electrocardiogram (ECG). All parameters are displayed to the doctor on the monitor.

After the infusion therapy at the command of an anesthesiologist-resuscitator, with the help of medical personnel, the patient is given a position in which anesthesia will be performed - sitting or on his side.

Classically, spinal anesthesia is performed from the position on the side, but sometimes it is more convenient to plant the patient, this is due to obesity.

If the patient takes a position on his side, he maximally presses the bent knees to the chest, grasps them with his hands, brings his head to his chest and archs his back.

When sitting, the patient relaxes and lowers his shoulders, bends his head and presses it to his chest, rests his hands on his knees and arches his back.

After giving the necessary position, the patient should follow the simple instructions of the anesthesia specialist-resuscitator: do not move, do not turn around, immediately talk about all the appearing complaints.

How do spinal anesthesia

To perform spinal anesthesia, the anesthesiologist-resuscitator doctor uses a special sterile kit.

After the preparation of the surgical field, the skin will be anesthetized, while the patient feels an injection, and immediately afterwards This cold and a slight feeling of bursting, which appears due to the spread of anesthetic in tissues. This may remind you of a dental procedure, where only the injection itself is painful, and after that, you do not experience pain.

Following a local anesthetic of the skin, a spinal needle is inserted in the same place. The needle passes through the skin, the subcutaneous fat, the ligaments of the vertebrae, the yellow ligament, passes through the epidural space and penetrates through the dura mater into the spinal space.

The anesthesiologist-resuscitator doctor disconnects the mandrren from the spinal needle (the needle that was in the needle cavity), and then the luminal begins to drip through its lumen.

The doctor connects the syringe to the lumen of the needle and slowly starts to inject the medicine. The drugs used in anesthesia are local anesthetics. Solutions of lidocaine 2%, bupivacaine (marcaine), 5%, dicaine,%

During the administration of the drug, the patient will begin to feel warmth spreading on the legs, a weak feeling of numbness and tingling.

After the drug is fully introduced, the anesthesiologist-resuscitator doctor removes the needle and glues the puncture site with a sterile napkin.

Upon completion, the patient is neatly stacked on the operating table.

How to assess the adequacy of anesthesia?

To assess the anesthesia and the development of the anesthesia unit, the anesthesiologist-resuscitator doctor uses the "pin-prink" techniques and a cold sample.

The first technique is to assess your pain and tactile sensitivity. It is used with a thin needle. The doctor prickes the patient with the sharp and blunt end of the needle, and the patient answers where he feels pain, where they are weak, and where they are absent.

The second method is performed using a gauze ball moistened with alcohol. When you touch the skin, the patient will feel cold. When conducting at the site of the block approach, cold sensations will be absent.

The patient will gradually feel how the sensitivity in the lower part of the trunk decreases. Legs will become heavy, and then independent movements will disappear altogether.

During the operation, the patient will be conscious, hear the operation, feel some pressure. You will not feel any painful sensations.

An anesthesiologist, resuscitator, if necessary, can prescribe light sedatives for superficial sleep and a more comfortable time for delivery.

After the operation, the patient is transferred to the gurney and delivered back to the ward. Sensitivity will be gradually restored and will return completely by the end of the day.

Please note that in the postoperative period it is necessary to follow the recommendations of an anesthesiologist, resuscitator:

• Keep bed rest strictly during the day! It is forbidden to get up and walk around the ward.

• During the postoperative day, you must drink at least 2000-2500 ml of fluid. It can be water, juice, mors, tea, coffee, compote.

• If you need to visit the lavatory, contact the medical staff, you will definitely be helped.

Possible complications of spinal anesthesia:

• Reduction of blood pressure (hypotension).

To avoid this complication, it is necessary to perform an infusion therapy, before the anesthesia, in a volume of 1000 ml. physiological solution.

• Total spinal anesthesia (CMA). • Reduction in the heart rate (heart rate) • Nausea • Back pain.

• Epidural or spinal hematoma.

If necessary, spinal anesthesia can be replaced by general anesthesia.

The reason for the transition to general anesthesia is the inadequacy of the local anesthetic distribution in the spinal space, because of which the necessary anesthesia block does not come and the patient feels that anesthesia is not acted. In this case, the anesthesiologist-resuscitator doctor, proceeds to perform general anesthesia according to a standard procedure.

Side effects of spinal anesthesia:

• Post-puncture headache remains one of the most frequent side effects of regional anesthesia.

The incidence of side effects is reduced when the anesthesiologist-intensive care physician uses thin spinal needles for anesthesia.

But this does not negate the recommendations!

If the patient ignores the recommendations, the postoperative period will be complicated by such formidable side effects, which include severe migraine (severe headache), persistent nausea and vomiting.

Spinal anesthesia remains the most common type of regional anesthesia.

Regardless of the type of operation, it requires the well-coordinated work of the anesthesia team and the strict observance of all recommendations by the patient.

Only after a conscientious approach to the performance of their duties, anesthesia will be qualitative and comfortable for the patient.

Doctor anesthesiologist-resuscitator Starostin D.O.

A source: http://www.medicalj.ru/maneuver/manipulation/1323-spinalnaya-anesteziya

Epidural narcosis: consequences, contraindications, complications, reviews

Every day a large number of operations are performed in medical clinics.

Surgery is impossible without proper anesthesia, that is, anesthesia is necessary, otherwise it will be unbearable to endure such pain. There are many types of anesthesia.

In the article we will understand what epidural anesthesia is, in what cases it can be used, whether there are contraindications.

What is epidural anesthesia

This type of anesthesia is one of the methods of regional anesthesia.

An epidural narcosis is the introduction of drugs directly into the epidural space of the spinal column through a catheter.

In the course of such anesthesia, it is possible to achieve the following results:

• Loss of pain sensitivity.
• The overall sensitivity decreases or disappears.
• Relaxation of muscles.

The mechanism of action of epidural anesthesia is connected with the fact that the drug penetrates through the dural couplings into the subarachnoid space, as a result of which the passage of nerve impulses is blocked.

Principle of epidural anesthesia

In humans, the vertebral column and nerve endings on the neck are in the dura mater.

The epidural region is located around the membrane and passes along the spine.

Nerves in the direction of the neck, arms and shoulders cross it, their inflammation leads to pain in the epidural region.

The medicine injected into this zone causes loss of sensitivity and dullness of pain. The transmission of nerve impulses is blocked, which gives such an effect.

When epidural anesthesia is used

Given that this type of anesthesia is used during surgery in various areas of the body, it can be said that the risk of application can be greater or less.

For example, anesthesia of the epidural breast, inguinal area, legs and abdomen is less risky than analgesia in the neck and arms.

The use of such an anesthesia for the head is impossible, because the innervation of this part of the body is carried out with the help of the craniocerebral system.

An epidural narcosis is most often used:

1. As a local anesthetic, unless surgical intervention is contemplated, for example, during labor.
2. In addition to general anesthesia, it is possible to reduce the number of opioids used.
3. Epidural anesthesia is often used in cesarean section.
4. In the postoperative period for the removal of the pain syndrome.
5. For therapy of back pain. In this case, steroid drugs and analgesics are injected into the epidural region.

What kind of anesthesia to give preference to general anesthesia or epidural, the doctor decides in each case.

Methods of epidural anesthesia

Every year, in the arsenal of physicians, there are more and more new tools for this kind of anesthesia.

When the doctors have a choice: general or epidural anesthesia, then, if possible, choose the latter.

A large selection of drugs for its conduct allows you to choose the most suitable option for each patient.

1. Continuous. In this case, the anesthetic is injected into the cerebrospinal space permanently. This way you can achieve the removal of pain for the entire period of the operation, and the medication will be required in this case less.
2. Periodic administration. The receipt of the drug is provided only when there is an urgent need for it.
3. Anesthesia on request of the patient. When using this method, the patient has a button under his hands. If there is a need for anesthesia, when you press it into the epidural area, part of the drug is given.

Doctors have such drugs that perfectly stop the pain syndrome, but retain mobility, and the consciousness is left clear.

In what cases is an epidural anesthetic

Most surgeons consider this method of anesthesia to be the most suitable during operations on the legs. It allows not only to remove the pain syndrome and relax as much muscle as possible, but also to reduce blood loss.

Indications for the use of epidural anesthesia can be of a different nature, for example:

1. This method is absolutely safe for the kidneys and the prostate gland.
2. Applicable for abdominal and pelvic organs.
3. It is widely used during surgery on the stomach, intestines.
4. It can be used for heart diseases and diabetes mellitus.

But this does not mean that epidural anesthesia is always used in such pathologies. Everything is decided in each case individually.

Contraindications for use

Epidural narcosis of contraindication has the following: categorical and relative. The first category includes:

• Presence of tuberculosis spondylitis or its complications.
• Inflammatory process on the back.
• Shock state as a result of trauma.
• In the presence of hypersensitivity to the drugs used.
• Pathologies of the nervous system.
• If the spine is severely deformed.
• The process of clotting of blood is broken.
• There are serious diseases of the intra-abdominal cavity.
• Intestinal obstruction.

Relative contraindications are much more extensive, they include:

• Excess weight.
• Bad state of the body.
• Chronic diseases of the spinal column.
• Childhood.
• Neurological diseases.
• Pronounced hypotension and many others.

The quality of epidural anesthesia will depend not only on the existing pathology and the state of the patient's health, but also on the preparation that is to be used.

Epidural anesthesia in cesarean section

When there are all indications for cesarean section, often epidural is used instead of general anesthesia. This method is chosen in advance, since it requires some preparation.

The introduction of the drug is made at a specific place at the level of the waist, where the nerve endings from the spinal cord come out. The drug is injected through a special tube-catheter, during the operation at any time, you can add the medicine.

As a result of such anesthesia, consciousness remains clear, and sensitivity below the belt disappears. A woman can see and hear doctors, but does not feel pain.

When there is a choice - epidural or general anesthesia for caesarean section - it is worth considering the indications and contraindications for anesthesia.

Indications for such anesthesia

Most often epidural anesthesia is used:

1. If the labor activity began ahead of time, for example, at 36-37 a week. Such anesthesia relaxes the pelvic muscles, and the baby's head experiences less heavy loads during the movement along the birth canal.
2. Severe hypertension.
3. Discoordination of labor, when different parts of the uterus contract with varying intensity. Epidural anesthesia can reduce the intensity of contraction.
4. With prolonged labor, when there is no full relaxation for a long time. This can lead to abnormalities of labor, so they use epidural anesthesia to make the woman gain strength.

Contraindications

In addition to the indications, in the case of caesarean section there are also contraindications for such anesthesia, they include:

• The presence of an inflammatory process at the puncture site.
• Infectious diseases.
• Allergic reaction to drugs.
• If there is a scar on the uterus.
• If the child is located transversely or occupies an oblique position.
• Narrow pelvis of the woman in childbirth.
• The big weight of the kid.
• If the woman herself does not want this type of anesthesia, then doctors can not use it against her will.

Before applying epidural anesthesia, the consequences, disadvantages and advantages should be taken into account.

Benefits of epidural anesthesia in cesarean section

The advantages of this type of anesthesia include:

1. A woman is conscious throughout the operation, there is no risk of intubation or aspiration.
2. There is no irritation of the upper respiratory tract, as with general anesthesia, which is particularly preferred for asthma patients.
3. The cardiovascular system works stably, since the drug acts gradually.
4. The relative ability to make movements is preserved.
5. With this anesthetic, you can increase the time of anesthesia, because an anesthetic is injected through the catheter at any time.
6. After the operation, opioid preparations can be administered to relieve the pain syndrome.

In addition to the pluses, it is necessary to note the shortcomings of such anesthesia.

Disadvantages of epidural anesthesia

Any method of surgical intervention, as well as anesthesia, has its drawbacks. The disadvantages of epidural analgesia include:

1. An anesthesiologist's mistake when administering the drug, when the medicine enters the interior of the vessel. This can lead to seizures, a sharp drop in blood pressure.
2. There is a danger of subarachnoidal injection, as a result of which a total spinal block develops.
3. To conduct such an anesthesia you need to have a good skill, since this anesthesia is the most difficult.
4. The drug begins to act only after 15-20 minutes, so surgery can not begin immediately.
5. There is a risk of inadequate anesthesia, when the nerve endings are not completely blocked, and discomfort remains during the operation.
6. It is necessary to select carefully the preparations for such anesthesia during caesarean section, as some can penetrate the placenta and cause disruption of the breathing and heart rhythm of the fetus.
7. After the operation, pain in the back, headache can be felt.

To make the right choice, if you have a cesarean section, epidural or general anesthesia, you need to weigh all the pros and cons. Take into account existing contraindications and choose the most appropriate type of anesthesia.

Complications of epidural anesthesia

An epidural narcosis complicates rather seldom, although such cases occur. Most often noted:

1. In 1 out of 20 patients, the drug does not work until the end, and the nerve endings are not completely blocked, which means that anesthesia will be ineffective.
2. In the presence of coagulopathy, there is a risk of formation of a hematoma.
3. Accidental damage during puncture of the dura mater can lead to the outflow of cerebrospinal fluid into the epidural region. This is fraught with a headache after surgery.
4. A large dose of pain medication may be toxic, which will result in ineffective blockade.
5. There may be side effects from the use of specific pain medications.

From all of the above, we can conclude that epidural anesthesia effects are severe for health in very rare cases.

Reviews about the use of epidural analgesia

Each organism is individual, therefore, if some are well tolerated by general anesthesia, then for others, epidural anesthesia is preferable. The reviews he has are mostly good.

Most patients note a good quality of anesthesia, women during caesarean section can see all the actions of doctors and hear the cry of their baby immediately after his birth. There is a good opportunity to significantly reduce the pain syndrome after the operation.

Many parturients say that in the presence of high blood pressure, the use of epidural Anesthesia makes it possible to keep indicators within the limits of the norm, which only positively affects the ancestral activities.

But without negative feedback also does not do. Some patients after such anesthesia feel a strong headache, pain in the back. There are also those on which the drug simply did not work, and the blockade of nerve endings did not occur.

Looking through all the reviews, you can draw only one conclusion: any kind of anesthesia requires a competent approach to the specialist.

Even if you treat negligently to the simplest anesthesia, do not calculate the dosage of the medicine, then you can get undesirable consequences, sometimes even very serious ones, and what to say about epidural.

All questions must be discussed with the doctor in advance, so that later there will be no undesirable manifestations.

Of course, it would be perfectly ideal if no one needed surgery, which means that anesthesia would not be needed. But our vital realities are such that sometimes operations can not be avoided in order to preserve life and health. Take care of yourself and be well.

A source: http://.ru/article/246168/narkoz-epiduralnyiy-posledstviya-protivopokazaniya-oslojneniya-otzyivyi

Consequences and complications of spinal anesthesia

One of the types of anesthesia during surgery is the spinal. It consists in the fact that the solution of the local anesthetic injectively enters the subarachnoid space of the spinal cord.

In the place where lumbar puncture is done, some types of anesthesia can be performed. Through this puncture, spinal anesthesia can be performed.

If a needle with a larger diameter is used, but with a smaller insertion depth, epidural anesthesia can be performed.

Applied anesthesia in the spine during the operation of hernias, gynecological operations, etc.

What is the difference between spinal anesthesia and epidural?

Spinal and epidural anesthesia

When using epidural anesthesia (peridural anesthesia), pulses are blocked at the level of the roots of the spinal nerves. And when spinal, this impulse is blocked already at the level of the spinal cord.

Compare them is not necessary, because they both have their own advantages and side effects, and each of them has its own field of application. They give a different effect, for this reason the choice of anesthesia for this or that operation will be different.

Risk factors

There are certain things that can complicate the course of the operation, or because of which there is a large percentage of the risk of complications after anesthesia.

• Diseases.
• Age of the patient.
• General health.

The causes of complications of such anesthesia are often violations of the technique of its anesthesia, individual intolerance to the anesthetic, concomitant pathologies of the patient's body. The disease plays an important role for the sake of which the operation will be performed.

Complications and consequences of spinal anesthesia

Back pain after puncture occurs, for example, in patients with herniated intervertebral discs

Complication is an almost instantaneous reaction of the body. If it occurs after a while - this is a consequence, which is often harder to treat. Puncture can have both mild complications and consequences, and serious ones.

The lungs can include headaches, bradycardia, lowering blood pressure (BP), respiratory distress, back pain during or after a puncture, urinary retention.

Severe consequences of spinal anesthesia: infection, allergic reaction, traumatic root injuries, spinal cord horn syndrome, meningitis, spinal hematoma.

It starts several hours after the puncture, can last up to a week.

It is well felt in an upright position, when the patient tries to sit or get up after the operation. When returning to the horizontal position, it passes.

In the case of a delayed urination, a catheterization of the bladder is prescribed. More often it occurs in males.

Such complications as a bradycardia, a decrease in blood pressure or a respiratory disorder can be observed immediately after the puncture and are eliminated medically at the same minute.

If the puncture is properly performed, there should be no pain, there is only some feeling of pressure in the back. The cause of pain during anesthesia can be a concomitant disease, pathological changes in the spine or a transferred operation.

Puncture also can provoke an exacerbation of chronic pain in the back. All features should explain the doctor - an anesthesiologist. Knowing all diseases of the patient, the doctor is obliged to warn about possible consequences of anesthesia.

The use of non-reusable needles causes an infectious meningitis.

Meningeal symptoms occur within the first 24 hours after surgery - this is a fever body, rigidity of the occipital muscles, tachycardia or bradycardia, symptoms of Kernig, Brudzinsky.

When carrying out spinal anesthesia, it is very important to follow all the rules of asepsis

Traumatic damage to the roots of the spinal cord is the main consequence and the most serious. Thus the patient can experience pains of legs, a loin, a sacrum, buttocks. With severe trauma, paresis or paralysis of the lower extremities is possible.

If the blood vessels are damaged, one of the possible complications may be a spinal hematoma. The main thing is to timely detect hematomas in order to avoid serious consequences.

To a rare, but rather dangerous condition can be attributed total spinal anesthesia.

Total spinal anesthesia or total block can develop for a variety of reasons, not necessarily the wrong technique of implementation. The role of needle selection, choice of anesthetic, peculiarities of the patient's condition, etc., can play a role.

Initial symptoms can be difficult breathing, hypotension, bradycardia, after which a drop in stroke volume and heart rate (heart rate) may occur.

Then there is a development of respiratory failure, which develops due to paralysis of the intercostal muscles. Other manifestations may be weakness of the upper limbs, dilated pupils, loss of consciousness.

It is extremely important to recognize the danger in time and provide first aid.

Spinal puncture is extremely important both for diagnostic purposes and for the treatment of diseases. It has its own indications and contraindications.

But there are risk factors that depend on the patient, about which the doctor should warn him and be ready himself to provide first aid.

Attention!The information on the site is presented by specialists, but is of a fact-finding nature and can not be used for self-treatment. Be sure to consult a doctor!
A source: http://VseOperacii.com/narkoz/posledstviya-spinalnoj-anestezii.html