What are the main differences (risks) between General and Spinal Anesthesia?
I have heard that general is different of spinal anesthesia and there are several risks for the latter. Could you comment on that?
Answers:
I'm an anesthesiologist, and do lots of both spinal and general anesthetics. (Spinals are my favorite, though). Most times, spinal anesthetics are supplemented with sedation to prevent the patient feeling anxious, bored or restless.
A general anesthetic is a drug-induced state of unconsciousness. It is basically numbing the brain, so you don't feel, move, or remember anything. For most operations, we put a breathing tube in and stick you on a ventilator. There are loads of risks with generals, starting with nausea, vomiting and sore throat (very common), and going all the way to aspiration pneumonitis, heart attack, stroke, permanent neurologic injury and death. (Fortunately, quite rare.) One of the big risks is not being able to get the breathing tube in, which can be a real challenge in some people. General anesthesia lowers blood pressure and makes the heart beat less efficiently.
Spinal anesthesia is an injection of local anesthetic (numbing medicine) into the sac of spinal fluid that is below your spinal cord. It numbs the nerves from about the waist down, although we can get it to go a little higher with higher doses of drug and positioning changes after injection. (We can also make it more one-sided that way if we want to ). It is probably less risky than general for most people, and is significantly less risky than general for pregnant patients, those with severe lung disease, those with difficult airways, and some other patients. The risks of spinal anesthesia are bleeding and infection (minimized by the use of small needles and sterile technique), low blood pressure and sequelae that may follow that (low BP is treated with drugs and fluids easily for most people), and the chance of a spinal headache (less than 1% with use of "pencil point", small gauge needles - I'm a fan of the 25g Whitacre, myself).
For healthy patients, the risks are pretty low for both techniques. For sick (I'm talking chronic cardio-respiratory issues) people, spinals are frequently the only way to go.
I did podcasts on these techniques. Here is a list of the anesthesia related ones:
http://www.medicalminutepodcast.com/?cat...
I've also had surgery with both, and felt great after the spinal. Not so much with the general. You can always tell the spinal patients in recovery room - they're awake and looking good.
Spinals sound a lot scarier than they are. I've done thousands of them.
General anesthesia means they put you to sleep and you aren't aware of anything until its over.
Spinal anesthesia is when the freeze the bottom half of your body with an injection to the spine. This is not only uncomfortable and could be painful but most people who have had spinal anesthesia end up having migraine headaches for the rest of their life. I would not recommend it.
A general will be shot into the area that will be worked on. For instance if someone is working on your hand or foot, the doctor may shoot a general anesthesia into that area and wait until it numbs. Same thing when you go to the dentist and he shoots novocain into your gums.
A spinal is shot directly into the spine. These are sometimes called a saddle block. A lot of times people have problems long after they get one. Ask someone who has had a baby and see what they say if they had one.
Good Luck!
During a general, you are asleep completely. You have no idea what they are doing. In a spinal, medication is injected into the dura (the coating surrounding the spinal cord.) This can cause headache, however it is rarely of an significant nature. Pain medication can be given if they are to severe. An epidural is similar to a spinal, but the medication is injected just outside the dura. Both are effective, but the spinal requires less medication and works quicker.
BTW what PJ M is refering to is not a general, but a local.
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Answers:
I'm an anesthesiologist, and do lots of both spinal and general anesthetics. (Spinals are my favorite, though). Most times, spinal anesthetics are supplemented with sedation to prevent the patient feeling anxious, bored or restless.
A general anesthetic is a drug-induced state of unconsciousness. It is basically numbing the brain, so you don't feel, move, or remember anything. For most operations, we put a breathing tube in and stick you on a ventilator. There are loads of risks with generals, starting with nausea, vomiting and sore throat (very common), and going all the way to aspiration pneumonitis, heart attack, stroke, permanent neurologic injury and death. (Fortunately, quite rare.) One of the big risks is not being able to get the breathing tube in, which can be a real challenge in some people. General anesthesia lowers blood pressure and makes the heart beat less efficiently.
Spinal anesthesia is an injection of local anesthetic (numbing medicine) into the sac of spinal fluid that is below your spinal cord. It numbs the nerves from about the waist down, although we can get it to go a little higher with higher doses of drug and positioning changes after injection. (We can also make it more one-sided that way if we want to ). It is probably less risky than general for most people, and is significantly less risky than general for pregnant patients, those with severe lung disease, those with difficult airways, and some other patients. The risks of spinal anesthesia are bleeding and infection (minimized by the use of small needles and sterile technique), low blood pressure and sequelae that may follow that (low BP is treated with drugs and fluids easily for most people), and the chance of a spinal headache (less than 1% with use of "pencil point", small gauge needles - I'm a fan of the 25g Whitacre, myself).
For healthy patients, the risks are pretty low for both techniques. For sick (I'm talking chronic cardio-respiratory issues) people, spinals are frequently the only way to go.
I did podcasts on these techniques. Here is a list of the anesthesia related ones:
http://www.medicalminutepodcast.com/?cat...
I've also had surgery with both, and felt great after the spinal. Not so much with the general. You can always tell the spinal patients in recovery room - they're awake and looking good.
Spinals sound a lot scarier than they are. I've done thousands of them.
General anesthesia means they put you to sleep and you aren't aware of anything until its over.
Spinal anesthesia is when the freeze the bottom half of your body with an injection to the spine. This is not only uncomfortable and could be painful but most people who have had spinal anesthesia end up having migraine headaches for the rest of their life. I would not recommend it.
A general will be shot into the area that will be worked on. For instance if someone is working on your hand or foot, the doctor may shoot a general anesthesia into that area and wait until it numbs. Same thing when you go to the dentist and he shoots novocain into your gums.
A spinal is shot directly into the spine. These are sometimes called a saddle block. A lot of times people have problems long after they get one. Ask someone who has had a baby and see what they say if they had one.
Good Luck!
During a general, you are asleep completely. You have no idea what they are doing. In a spinal, medication is injected into the dura (the coating surrounding the spinal cord.) This can cause headache, however it is rarely of an significant nature. Pain medication can be given if they are to severe. An epidural is similar to a spinal, but the medication is injected just outside the dura. Both are effective, but the spinal requires less medication and works quicker.
BTW what PJ M is refering to is not a general, but a local.
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