Preparing for spinal anaesthesia

Overview

Spinal anaesthesia is a type of pain relief that numbs the lower half of your body during surgery. A small injection of medicine is given into the fluid around your spinal cord, so you stay awake but feel no pain from your belly button downwards.

Yes, spinal anaesthesia is a very common and safe method used for many types of surgery, especially those on the lower body, such as hip replacements, caesarean sections, and leg operations.

It can be used for anyone needing surgery on the lower half of the body, including adults of all ages and, in some cases, children. Your anaesthetist will decide if it is suitable for you based on your health and the type of surgery.

Symptoms

Common symptoms

• Numbness and loss of movement in your legs during the procedure
• A feeling of pins and needles as the numbness wears off
• Low blood pressure, which may cause light-headedness or nausea
• Headache after the injection (spinal headache) – this is less common with modern techniques

Symptoms in children

• Children may feel more anxious about the injection, so distraction and gentle reassurance are used.
• The same numbness and temporary loss of leg movement occur, but children usually recover quickly.

Symptoms in older adults

• Older adults may be more prone to low blood pressure after the spinal injection.
• There is a slightly higher risk of confusion or bladder problems after the anaesthesia wears off.

Causes

Main causes

• Spinal anaesthesia is not a condition but a planned medical procedure. The 'cause' is the decision to use it for a surgical operation on the lower body.

Risk factors

• Taking blood-thinning medicines (like warfarin or clopidogrel) – these increase bleeding risk
• An infection near the injection site (e.g., a skin infection on your back)
• A known allergy to the anaesthetic medicines
• Certain spinal conditions, such as severe scoliosis or previous spinal surgery
• Low platelet count or bleeding disorders

When to see a doctor

See a doctor urgently if:

• If you develop a severe headache that does not go away after resting and taking simple pain relief
• If you have new numbness or weakness in your legs more than 24 hours after the procedure
• If you have difficulty passing urine

Book a routine appointment if:

• Discuss any concerns with your anaesthetist before the surgery during the pre-operative assessment.
• If you have a history of headaches or back problems, mention it during this assessment.

Diagnosis

There is no diagnosis for spinal anaesthesia – it is a procedure you choose to have. Instead, your anaesthetist will assess your health to make sure it is safe for you. This includes a pre-operative check-up.

Tests that may be done

• Blood tests (to check for bleeding risk or infection)
• Electrocardiogram (ECG) if you have heart problems
• Review of your medical history and current medications

What to expect at your appointment

Before the procedure, you will meet your anaesthetist who will explain the process, answer your questions, and ask about your health. On the day of surgery, you will be given the injection while you are lying on your side or sitting up. It takes about 10 to 15 minutes for the numbness to start, and then the surgery can begin.

Treatment

Spinal anaesthesia is itself a treatment for pain during surgery. After the procedure, the main focus is on recovery and managing any side effects.

Self-care at home

• Rest lying flat for a few hours after the injection to help prevent headache.
• Drink plenty of fluids (unless your doctor advises otherwise).
• Take simple pain relief like paracetamol for any headache or backache (follow your doctor's advice).
• If you have a headache that gets worse when you sit up, lie flat and avoid straining.

Medical treatments

Your healthcare team will monitor your blood pressure and heart rate during and after the procedure. If you develop a spinal headache, treatments can include bed rest, caffeine, or a procedure called a blood patch, where a small amount of your own blood is injected into the space around your spine to seal the leak. This is very effective. Your doctor will discuss the best options for you.

When is surgery considered?

Spinal anaesthesia is used for surgery, so the surgery itself is the main treatment. The anaesthetic allows the surgeon to operate without you feeling pain.

Living with this condition

After spinal anaesthesia, most people return to their normal activities within a day or two. It is important to follow the specific aftercare advice given by your healthcare team, especially regarding driving, lifting, and returning to work.

Lifestyle tips

• Avoid driving for at least 24 hours, or longer if you are taking strong painkillers.
• Do not operate heavy machinery or make important decisions until the effects have worn off completely.
• If you had leg surgery, follow your physiotherapist's advice on moving around safely.

Diet and exercise

You can usually eat and drink normally as soon as you feel ready. Light activity like walking is fine, but avoid strenuous exercise or heavy lifting for a few days. Your doctor or physiotherapist will give you specific advice based on your surgery.

Mental health and emotional wellbeing

Some people may feel anxious before the procedure or during recovery. It is normal to worry, but remember that spinal anaesthesia is very safe. If you have ongoing anxiety, talk to your healthcare team – they can offer support and information.

Prevention

Spinal anaesthesia is a planned procedure, so prevention is about reducing the risk of side effects. You can help by giving your anaesthetist a full list of your medicines and health conditions, and by following pre-operative instructions (like fasting).

Vaccines

No specific vaccines are needed before spinal anaesthesia, but it is important to be up-to-date with routine vaccinations to avoid infections that could complicate surgery.

Screening programmes

Your anaesthetist will do a pre-operative assessment. There is no special screening test for spinal anaesthesia itself.

Complications

If left untreated

• A spinal headache that is not treated can become very painful and make it hard to function.
• Very rarely, a collection of blood or infection near the spine could cause nerve damage if left untreated.
• Failure to manage low blood pressure could lead to dizziness or fainting during the procedure.

Long-term outlook

The outlook after spinal anaesthesia is excellent. Serious complications are very rare. Most people recover smoothly without any lasting effects. Your healthcare team will take every precaution to keep you safe.

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