Anesthesia (Lumbar Puncture, Spinal Anesthesia)
What is Spinal Anesthesia
The use of a needle to introduce anesthesia into the spinal canal is called spinal anesthesia. Other names for this procedure are spinal block and subarachnoid block. A long, fine needle is inserted into the lumbar portion of the spinal column, below the L2 section. This is to prevent any possible piercing of the spinal cord.
There’s significant confusion with most people when discussing spinal versus epidurals. This is because both are performed with the same type o equipment, except or some major differences in how the medications work. Epidurals use a catheter to give medication, while spinals are usually one injection. Epidurals work slower than spirals which can work in as little as five minutes. A spinal can cause a larger, more persistent neuro-muscular block compared to epidurals which need a specific type o anesthesia for this to occur.
There are many types of injectables used with spinal anesthesia. Most are in the ‘caine’ family – bupivacaine, lidocaine, tetracaine, procaine, and more. Opioids are used to create a longer lasting block and also to help with post-operative pain. The way that the anesthesia spreads in the spinal fluid is referred to as ‘baricity’ and is what Anesthetist uses to determine the best anesthesia for the job. Hyperbaric solutions are used most and are easily controlled by tilting patients. Glucose is added to the anesthesia mixture to help speed the spread of the medication through the spinal fluid which helps speed the onset of pain relief or of numbing qualities for surgery.
A lumbar puncture is also known as a spinal tap. It removes spinal fluid from the spinal column for the doctor to examine.
Spinal anesthesia is very useful for people that have a severe respiratory disease like COPD or emphysema. The reason being that intubation is avoided along with ventilation. Births using spinal anesthesia allow the mother to be awake o see her child and her partner be present during the event.
A spinal injection can also be used to supply painkilling medication for patients that have chronic pain. The nerve blocks are useful and can help those that are unable to take traditional oral painkillers.
A lumbar puncture or spinal tap is used to determine if a patient is suffering from meningitis or has a subarachnoid hemorrhage. The procedure has been used for years and has a safe track record. The needle is placed in the subarachnoid space and fluid is then collected in a syringe.
Recovery From Lumbar Puncture/ Spinal Anesthesia
Recovery from this type of anesthesia is similar to epidural recovery. As with the epidural, there are common side effects during recovery, the most common being a headache. When sensation begins to come back to the numbed area, it may feel like pins and needles or it could be a strong tingling sensation.
Movement may be very hard at first. When trying to stand or walk for the first time, a nurse should be present in the case of a fall. Patients should not try to get up without help until the spinal has fully worn off and all sensation has returned. Serious injuries are possible when patients try to move on their own before the spinal has worn off fully. Their legs cannot bear weight or be controlled. By following the instructions of the doctor or nurse present, patients can reduce the incidence of injury due to numb legs or feet.
A lumbar puncture has a quick recovery time in most cases. The most common side effect is a strong headache. In the past patients would lie on their back following the procedure for about six hours. During this time a nurse or doctor would monitor the patient for neurological abnormalities relating to any possible spinal injury during the spinal tap.