A fast-acting regional anesthesia method in which medication is injected into the cerebrospinal fluid through a fine needle in the lower back to numb the lower body.
Indication
- Cesarean sections and analgesia for vaginal delivery
- Lower abdominal surgeries (hernia repair, urological procedures)
- Lower extremity orthopedic surgeries such as hip and knee replacement
- Endoscopic prostate and bladder procedures (TUR-P, TUR-M)
- Varicose vein and perineal surgeries
- Lower body surgeries in patients for whom general anesthesia carries higher risk
Preparation
- Anesthesia consultation, blood tests, and coagulation tests
- Stopping solid food 6 hours and clear liquids 2 hours before the procedure
- Adjustment of blood thinners (aspirin, warfarin, new-generation anticoagulants) with physician approval
- Reporting any previous spine surgery, spinal problems, and neurological complaints
- An IV line is opened and fluid administration is started
How it's performed
- The patient is positioned sitting or lying on their side, with the lower back curved forward
- The skin is cleaned with antiseptic solution and a sterile drape is placed
- After numbing the skin with local anesthetic, a fine spinal needle is advanced between the lumbar vertebrae
- Once cerebrospinal fluid flow is observed, the anesthetic medication is injected
- The procedure takes 5-10 minutes; the effect begins within minutes (numbness and immobility in the lower body)
- Blood pressure, heart rhythm, and oxygen levels are continuously monitored
Post-procedure
- The anesthetic effect lasts 1.5-3 hours; sensation and movement in the lower body return gradually
- The patient is not allowed to stand until full sensation and movement return; urination is monitored
- Adequate fluid intake is recommended for the first 24 hours
- A severe headache (especially when standing) should be reported to the physician
- Mild tenderness at the injection site may persist for 1-2 days
Risks
- Temporary low blood pressure and slowed heart rate (common, easily treated)
- Post-dural puncture headache (PDPH) — headache that worsens on standing; usually resolves within 5-7 days, with a blood patch applied if needed
- Nausea and difficulty urinating (transient)
- Back pain and brief tenderness at the needle site
- Very rare permanent nerve injury, hematoma, and infection
FAQ
Will I be awake during spinal anesthesia?
Yes, the patient remains conscious throughout the procedure; however, sedation can be given for comfort. Sensation and pain in the lower body are completely eliminated.
Could I become paralyzed after spinal anesthesia?
Permanent nerve injury is extremely rare. The needle is inserted below the level where the spinal cord ends. The temporary numbness is a natural consequence of the anesthetic effect.
Will I get a headache, and why?
In some patients, post-dural puncture headache (PDPH) may develop due to a small leak of cerebrospinal fluid through the needle hole. It is treated with bed rest, fluids, and a blood patch when needed.
Is spinal or general anesthesia safer for cesarean section?
In general, spinal anesthesia is preferred for cesarean section; the baby is exposed to less medication and the mother can participate in the surgery while awake. The decision is made based on the condition of mother and baby.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Epidural Anesthesia
Anesthesiology & Reanimation
Epidural anesthesia — placement of a catheter into the epidural space in the lower back to provide long-lasting pain control.
Epidural Anesthesia for Vaginal Delivery
Anesthesiology & Reanimation
Epidural anesthesia — pain management administered at the L3-L4 level for vaginal delivery.
Regional anesthesia
Anesthesiology & Reanimation
Regional anesthesia — numbing of a specific body region using a nerve block.
General Anesthesia
Anesthesiology & Reanimation
General anesthesia — an anesthetic method in which consciousness and pain sensation are completely eliminated for surgical procedures.
Sedation
Anesthesiology & Reanimation
Conscious sedation — an anesthesia method using calming and pain-relieving medications without complete loss of consciousness.
Local Anesthesia
Anesthesiology & Reanimation
Local anesthesia — a superficial anesthesia method in which only a small area of skin where the procedure will be performed is numbed.
Patient-Controlled Analgesia
Anesthesiology & Reanimation
Patient-controlled analgesia (PCA) — a safe system in which the patient determines their own pain medication dose.
Preoperative anesthesia evaluation
Anesthesiology & Reanimation
Preoperative anesthesia evaluation — anesthesia risk analysis and planning before surgery.