Risks and benefits of spinal anaesthesia

Overview

Spinal anaesthesia is a type of numbing medicine injected into the fluid around your spinal cord. It makes the lower half of your body go numb so you don’t feel pain during surgery. You stay awake or lightly sleepy, but you won't feel anything below your waist.

Yes, spinal anaesthesia is a common and well-established technique used in many hospitals around the world for certain types of surgery.

It can be used for people of all ages, including children and older adults, as long as they are healthy enough for the procedure. Your anaesthetist will decide if it is suitable for you based on your overall health and the type of surgery.

Symptoms

Common symptoms

• Numbness and lack of feeling in the lower half of your body during the procedure
• Mild headache after the injection – this is common and usually goes away with rest and fluids
• Low blood pressure, which may make you feel dizzy or light-headed
• Difficulty passing urine for a few hours after the anaesthetic wears off
• Shivering or feeling cold

Symptoms in children

• Children may feel restless or anxious during the injection
• Headache is less common in children but can still happen
• Some children may have a temporary drop in blood pressure
• Numbness might feel strange, but it passes quickly

Symptoms in older adults

• Older adults are more likely to experience a drop in blood pressure after spinal anaesthesia
• There may be a slightly higher risk of confusion or falls as the anaesthetic wears off
• Headache can occur but is less frequent in this age group
• Bladder problems (trouble urinating) may last a bit longer

Causes

Main causes

• Spinal anaesthesia is not a disease – it is a planned medical procedure. The 'causes' are the reasons your surgeon or anaesthetist may recommend it, such as avoiding general anaesthesia, reducing pain after surgery, or for specific operations like hip replacement or caesarean section.

Risk factors

• Bleeding problems or taking blood-thinning medicines
• Infection near the injection site on your back
• Certain spine problems, like a spinal tumour or severe scoliosis
• Low blood volume or dehydration
• Allergies to numbing medicines (rare)

When to see a doctor

See a doctor urgently if:

• If you have a severe headache after spinal anaesthesia that doesn't improve with simple pain relief and fluids
• If you develop numbness or weakness in your legs that lasts longer than expected
• If you have difficulty breathing or chest pain after the procedure

Book a routine appointment if:

• Before the procedure, you will have a detailed discussion with your anaesthetist to ask any questions
• After the procedure, you will be monitored until the anaesthetic wears off. Follow any discharge instructions given by your healthcare team.

Diagnosis

There is no diagnosis for spinal anaesthesia itself – it is a procedure. However, before the injection, your anaesthetist will ask about your medical history, check your vital signs, and may examine your back to choose the safest spot for the injection.

Tests that may be done

• Blood tests to check for bleeding or clotting problems
• A physical examination of your spine and nervous system
• Review of your current medicines, especially blood thinners

What to expect at your appointment

You will be asked to sit or lie on your side with your back curved. The anaesthetist will clean the area and inject a small amount of local numbing medicine into your skin before inserting the spinal needle. You might feel some pressure but not sharp pain. The medicine takes effect within minutes.

Treatment

Spinal anaesthesia is not a treatment for an illness – it is a way to manage pain during surgery. After the procedure, you will be given pain relief as needed, and the anaesthetic will wear off on its own. Your healthcare team will monitor you and treat any side effects.

Self-care at home

• Rest and drink plenty of fluids after the procedure to help prevent or relieve a headache
• Avoid driving or operating machinery for 24 hours, or as directed by your doctor
• Do not try to walk until you have full feeling and strength in your legs
• Tell a nurse if you have trouble urinating – they can help

Medical treatments

If you develop a headache that does not go away with rest and simple pain relief, your doctor may recommend a special procedure called a blood patch, which involves injecting a small amount of your own blood near the injection site to seal any leak. Low blood pressure can be treated with fluids and medicines. For difficulty urinating, a temporary urinary catheter may be used.

When is surgery considered?

Spinal anaesthesia is often used for surgeries on the lower half of the body, such as hip or knee replacement, hernia repair, caesarean section, and some urological or gynaecological procedures.

Living with this condition

Spinal anaesthesia is a one-time event. After the anaesthetic wears off, you can go back to your normal activities as advised by your surgeon. Some people feel tired or a little sore at the injection site for a day or two.

Lifestyle tips

• If you had a headache, avoid straining or heavy lifting until it clears
• Drink plenty of water in the first 24 hours
• Follow your surgeon’s instructions for recovery after the surgery itself

Diet and exercise

There are no special dietary restrictions after spinal anaesthesia. You can eat and drink as soon as you feel ready and your healthcare team says it is safe. Gentle movement, such as walking, can help you get back to normal, but avoid strenuous exercise until your medical team approves.

Mental health and emotional wellbeing

It is normal to feel anxious before any anaesthetic. Talking to your anaesthetist about your concerns can help. After the procedure, some people feel relief that the surgery went well. If you experience ongoing worry or feel down, talk to your doctor – they can offer support or refer you to a counsellor.

Prevention

Spinal anaesthesia is not something you prevent – it is a planned choice. However, you can help reduce the risk of complications by telling your medical team about all your health conditions and medicines, and by following their instructions before the procedure.

Complications

If left untreated

• Severe headache that does not get better can affect daily activities and may need further treatment
• Ongoing numbness or weakness in the legs could indicate a rare nerve problem
• An untreated infection at the injection site could spread (very rare)

Long-term outlook

Spinal anaesthesia is very safe for most people. Serious complications are rare. Minor side effects like headache or low blood pressure are common and usually resolve quickly with simple care. Your healthcare team will guide you through a full recovery from both the anaesthetic and your surgery.

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