Everything about Spinal Anesthesia totally explained
Spinal analgesia, (or commonly called
spinal anesthesia) is a form of
regional anaesthesia involving injection of a
local anaesthetic into the
cerebrospinal fluid (CSF), generally through a long, fine
needle.
There are hyperbaric, isobaric, hypobaric solutions of anesthetics to choose for the spinal anesthesia. Usually, the hyperbaric is chosen.
Bupivacaine is the local anesthetic most commonly used, although
lignocaine (
lidocaine),
tetracaine,
procaine, ropivacaine, levobupivicaine and
cinchocaine are also available. Sometimes a
vasoconstrictor such as epinephrine is added to the local anesthetic to prolong its duration. Regardless of the
anaesthetic agent used, the desired effect is to block the transmission of nerve signals to and from the affected area. Sensory signals from the site are blocked, thereby eliminating pain, and motor signals to the area eliminate movement. In effect, the result is total numbness of the area and paralysis. This allows medical procedures to be performed with little or no sensation whatsoever to the person undergoing the procedure, and provides a still patient or area for the surgeon to work on. Some
sedation is sometimes provided to help the patient relax and pass the time during the procedure, but with a successful spinal anesthetic the
surgery can be performed with the patient wide awake. Spinal anesthetics are limited to procedures involving most structures below the upper
abdomen, as to administer a spinal anesthetic higher may affect the ability to breathe by paralyzing the intercostal respiratory muscles, or even the
diaphragm in extreme cases (called a "high spinal", or a "total spinal", with which consciousness is lost), as well as the body's ability to control the
heart rate via the cardiac accelerator fibers.
Baricity refers to the density of a substance compared to the density of human cerebral spinal fluid. Baricity is used in
anesthesia to determine the manner in which a particular drug will spread in the
intrathecal space.
History
The first spinal analgesia was administered in 1885 by
Leonard Corning (1855-1923), a neurologist in New York. He was experimenting with
cocaine on the
spinal nerves of a dog when he accidentally pierced the
dura mater.
The first planned spinal anesthesia for surgery in man was administered by
August Bier (1861-1949) on 16th August 1898, in
Kiel, when he injected 3 ml of 0.5% cocaine solution into a 34 year old laborer. After using it on 6 patients, he and his assistant each injected cocaine into the other's
spine. They recommended it for surgeries of legs, but gave it up due to the toxicity of
cocaine.
Complications
During the procedure
Further Information
Get more info on 'Spinal Anesthesia'.
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