Spinal anesthesia is a crucial factor that many expectant mothers think about when having a cesarean section. This kind of anesthesia provides a means of guaranteeing patient comfort and safety throughout the process. Spinal anesthesia numbs the lower body while you are awake and conscious, as opposed to general anesthesia, which renders you unconscious.
Gaining knowledge about spinal anesthesia can make you feel less scared and more prepared for the procedure. By injecting a local anesthetic into the spinal fluid, this technique prevents lower body pain. The effects happen quickly and precisely, making the delivery experience more seamless and in control.
This article will discuss the advantages of spinal anesthesia, how it operates, and what to anticipate if you require a cesarean section. Our objective is to give you accurate and useful information so you can decide on your birthing plan with confidence.
- What is it?
- How to conduct?
- Possible consequences and complications
- Contraindications
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What is it?
The nerve endings in the human spinal column are what drive the central nervous system’s functions. These endings are responsible for continuously sending specific impulses to the brain. Inhibiting the transmission of these "messages" will prevent the brain from receiving signals related to touch, pain, or cold. Spinal anesthesia for cesarean sections is based on this.
Because the procedure involves making an incision and penetrating the abdominal cavity, anesthesia must always be used during the procedure. However, there are various forms of anesthesia available for this procedure, making the choice of anesthesia rather challenging. Regional anesthesia includes both spinal and epidural anesthesia.
The only distinction between the two is that, in the case of epidural anesthesia, the drugs are injected into the epidural space, whereas in the case of spinal anesthesia, they are injected into the subarachnoid space of the spine, which is a little deeper than in the first instance.
Blocking nerve impulses at the level of the spinal nerve roots is made possible by this kind of penetration. Preservatives are not present in the highly purified medications that are given during a cesarean section. This is typically one of the anesthetics (like lidocaine) plus an opiate (like promedol). Recently, ketamine has been used a lot.
In terms of pain relief, spinal anesthesia is thought to be superior to epidural anesthesia. It is also thought to be superior to general anesthesia because it is easier to come out of and does not cause severe dizziness or nausea.
Throughout the entire procedure, the patient remains conscious, comprehends everything, and can converse with the medical staff. However, he lacks sensation in his lower body, ranging from the lower back to the tips of his toes. A woman’s upper body still has sensitivity, allowing her to move her head and hands, giving her the rare chance to embrace her newborn right away. In fact, many laboring women insist on spinal anesthesia precisely for this reason.
How to conduct?
Lumbar punctures are used to introduce medications into the spine. Simultaneously, the woman either lies on his side, tilting her head to her chest, or sits, leaning forward as much as possible. The anesthetist inserts the puncture needle into the lumbar spine to begin the anesthesia of the lower body. The space between the vertebrae is where the introduction point is. In comparison to when using epidural anesthesia, the needle itself is thinner. The needle needs to avoid touching the yellow ligament that separates the vertebrae, go through the subarachnoid space that contains cerebrospinal fluid instead of the epidural space.
It should be mentioned that spinal anesthesia acts much more quickly and requires less medication than epidural anesthesia. While spinal anesthesia causes numbness in the lower body and a subsequent loss of sensation shortly after administration, epidural anesthesia typically relieves pain within 15 minutes.
In order to provide long-lasting pain relief during a cesarean section, the medication is typically injected between two vertebrae, specifically between the second and fifth lumbar vertebrae. Physicians typically select a point between the second and third lumbar vertebrae.
How painful is it? is a question that women frequently pose. The majority of the time, a laboring woman does not feel intense pain. As with any injection, there may be some temporary discomfort, depending on personal sensitivity. It is the woman’s responsibility to let the anesthesiologist know if she is uncomfortable. The most important thing is to avoid looking at the specialist or turning to him. Throughout all communication, the woman should maintain her posture.
Once the puncture site is confirmed, the physician administers a test dosage of the medication. If there are no unfavorable symptoms after three to five minutes, the remaining material is injected gradually. By varying the dosage of the medications given, the surgeon can modify the level of blockage during the procedure.
The back catheter is taken out when the surgeon indicates that the procedure is finished. Following her transfer to the intensive care unit, the woman is closely observed for several hours by both the anesthesiologist and the obstetricians to ensure a smooth recovery from anesthesia. It takes roughly two hours.
For cesarean sections, spinal anesthesia is a popular option because it provides mothers with efficient pain relief and a speedy recovery. Spinal anesthesia, as opposed to general anesthesia, minimizes pain from the chest down while enabling the mother to give birth while awake and conscious. This approach is favored for many deliveries since it carries a decreased risk of complications for the mother and the child.
Possible consequences and complications
It is thought that spinal anesthesia is a reasonably safe way to relieve pain. According to data from the Russian Ministry of Health, there is a 0.01% chance of serious or deadly complications. This indicates that there was only one patient death, due to acute heart failure, for every 10,000 procedures utilizing this kind of anesthesia.
Following surgery, many women report having headaches and back pain. Post-puncture pain affects 7–10% of laboring women and is a fairly common occurrence. It is transient and, with no special care, usually goes away entirely in two to three months.
A decrease in blood pressure in the initial postoperative phase is another potential side effect of spinal anesthesia. In about 2-3% of cases, this happens. Drugs that raise blood pressure are used to bring the situation under control.
A lot is dependent on the anesthesiologist’s degree of education, experience, and credentials. A novice or unskilled physician may damage the spinal cord or the hard shells of the vertebrae, which could result in a variety of disorders related to the central nervous system, ranging from paralysis to a persistent numbness in the limbs. Statistics show that although the likelihood of these complications is small, they do occur.
In fifteen percent of cases, a stable analgesic effect cannot be achieved, and the laboring woman’s sensitivity can only be partially preserved. This is highly undesirable for the patient as well as the operating physician.
In the event of coagulopathy, or a disruption in blood coagulation, a tiny bleeding known as a hematoma may develop at the site of puncture. Medication administration in the subarachnoid space necessitates accuracy because injury to this area can result in paralysis and seizures.
The baby is less affected by the medications than with epidural and general anesthesia because the dosages are lower than with other forms of anesthesia. However, during the neonatal period, there is still a slight chance of heart rate irregularities, respiratory weakness, hypoxia, and muscle hypotension.
Some women draw attention to the psychologically challenging nature of spinal anesthesia operations; it is not as simple for the psyche as it may seem to be to be conscious and realize that you are the one being cut on the table, as well as to hear the doctors’ conversations while the procedure is going on. When an operation is starting, especially sensitive women begin to insist that their doctors give them general anesthesia so that they can go to sleep and wake up only after everything is finished.
Contraindications
This kind of anesthesia is contraindicated for two different reasons. Certain things are absolute, while others are relative. Spinal anesthesia should never be administered to a woman who has:
- severe blood clotting disorders;
- infectious and inflammatory diseases of the skin in the area of the 2-5 lumbar vertebrae, that is, where the puncture needle is supposed to be inserted;
- high intracranial pressure;
- spinal injuries, deformation of the spinal column;
- severe heart disease.
The following are relative disqualifiers for spinal anesthesia:
- severe psychological and emotional disorders of the pregnant woman, mental illness;
- indefinite duration of the operation (if, for example, doctors assume that amputation of the uterus may be required due to placenta accreta or the woman has agreed to surgical sterilization after a cesarean section);
- death of the fetus;
- bleeding in a woman or suspected bleeding.
Furthermore, in the event that the cesarean section is performed for emergency indications rather than on a planned basis, the patient will not be granted spinal anesthesia. In this situation, it is best to use general (endotracheal) anesthesia in order to remove the child from the mother’s womb as soon as possible.
| Aspect | Description |
| What It Is | Spinal anesthesia is a type of regional anesthesia used to numb the lower half of the body. It is commonly used for cesarean sections. |
| How It Works | A local anesthetic is injected into the spinal fluid, which blocks the nerves in the lower body, allowing the mother to be awake during the procedure without feeling pain. |
| Benefits | Provides effective pain relief, allows the mother to be awake and alert, and has a quicker recovery time compared to general anesthesia. |
| Risks | Possible risks include headaches, low blood pressure, or in rare cases, infection or bleeding in the spinal area. |
| Preparation | The mother will be given instructions to avoid eating or drinking before the procedure. An IV line will be set up for fluids and medications. |
| Procedure | The injection is usually administered while the mother is sitting up or lying on her side. The anesthetic takes effect within minutes. |
| Recovery | Recovery from spinal anesthesia is generally quick. The mother will be monitored for any side effects and will need to lie flat for a short period to prevent headaches. |
Because it is safe and effective, spinal anesthesia is a commonly used option for cesarean sections. By injecting medication into the spinal fluid, this technique blocks feeling from the waist down, enabling the mother to stay conscious and awake throughout the process. Many women value not having to worry about the additional risks associated with general anesthesia and being able to witness their baby’s birth while still being aware and involved.
Quick onset and precise control of pain relief is one of the main advantages of spinal anesthesia, and it can help facilitate a more comfortable recovery process. In contrast to other forms of anesthesia, it usually permits a quicker return to complete mobility. It does, however, have its own set of risks and possible side effects, like headaches or a drop in blood pressure, just like any medical procedure.
In the end, spinal anesthesia is a tried-and-true technique that helps many mothers have a more comfortable birthing experience during cesarean sections. It is imperative that expectant parents confer with their healthcare provider to ascertain the optimal course of action based on their unique needs and circumstances. Making an informed decision to ensure a positive birth experience can be aided by being aware of the advantages and possible risks.
