While most people think that having an anaesthetic is akin to being asleep, there are numerous operations that can be performed without being asleep. In the same way as having dental work done with a local anaesthetic, many operations can be performed under regional anaesthesia. Regional anaesthesia does not require the person to be asleep. You can be wide awake, calm, drowsy or completely asleep. The sedation given to you during this sort of anaesthesia makes you forget most of the operation even though you were awake.

Spinal anaesthesia is a form of regional anaesthesia (Regional anaesthesia refers to blocking the nerve supply to a part of the body which is being operated upon, so that the patient cannot feel pain in that area). It involves injection of a local anaesthetic into the cerebrospinal fluid (CSF), generally through a long, fine needle. Bupivacaine is the local anaesthetic most commonly used. This renders the portion of the body beyond or below (as the case may be) the point of injection numb and anaesthetized, while the rest of the body remains unanaesthetised. Some sedation is usually provided to help the patient relax during the procedure.

The injection is usually administered in the lumbar (low back) spine, (fig.1). This form of anaesthesia is easy to administer and is ideal for surgeries performed in the lower parts of the body (gynaecological surgery, genito- urinary surgery).

The patient is usually positioned in a sitting posture on the operating table. Alternatively,

the procedure can be performed with the patient lying on their side with their hips and knees maximally flexed (fig. 2).

Figure: 1

Following positioning, the anaesthetist will clean your back using an antiseptic solution. He may administer a little bit of local anaesthetic to numb the skin at the point where he would give the spinal, so that you don’t feel the pain due to passage of the spinal needle. The local anaesthetic solution is then injected into the spinal space through a long needle. After successful administration, you will be placed in the required position and once again all your parameters will be checked by the anaesthetist.

Advantages

Relatively cheap

Higher patient satisfaction

Reduced risk of respiratory complications

Superior muscle relaxation, less bleeding, quick restoration of bowel function and reduced incidence of coagulation disorders following surgery.

After your spinal

Your nurses will make sure that the numb area is protected from pressure and injury until sensation returns.

It takes one-and-a-half to four hours (1