Main Difference – Spinal vs Epidural Anesthesia
The main difference between Spinal and Epidural Anesthesia is that spinal anesthesia involves injecting the drug to the cerebrospinal fluid whereas epidural anesthesia involves passing the medication into the epidural space through a catheter. There are many other differences between the two, but it’s important to know what is anesthesia before looking at these differences.
This article will discuss,
1. What is Anesthesia?
– Purpose, Types
2. What is Spinal Anesthesia?
– Features, Procedure, Effect
3. What is Epidural Anesthesia?
-Features, Procedure, Effect and Risks
4. What is the difference between Spinal and Epidural Anesthesia?
What is Anesthesia
Anesthesia, which provides patients with a comfortable and painless therapeutic interventional experience whenever necessary, is a revolutionary invention in the medical field. The major purpose of anesthesia is to numb the nerves which are responsible for conducting sensations related to pain, resulting in an effective pain relief.
There are several types of anesthesia, which can fall into groups of local, regional and general anesthetizing agents, depending on the nature of the treatment.
Types of Anesthesia
General anesthesia – Affects the whole body including the brain; it is administered intravenously or through inhalation. With this type of anesthesia, you will be completely unconscious without having to experience any pain. This is mostly used in major surgeries.
Regional anesthesia – Can either be peripheral nerve blocks, spinal or epidural anesthesia which numb a larger region of the body.
Local anesthesia – A type used in minor surgeries where a small part of your body will become numb. You will stay awake during the procedure.
Spinal and epidural anesthesia which fall under the category of regional anesthesia have several distinguishable features, but most people tend to confuse them often as a result of a lack of clear knowledge about what they really are. From this article, let’s talk about these two types, their uses and how they differ from one another.
What is Spinal Anesthesia
This is a type of regional anesthesia which is injected through a tiny needle, right into the cerebrospinal fluid (CSF) which covers and protects the spinal cord. The skin area of insertion will first made numb using a local anesthetizing agent which will then be followed by the insertion of the need into the spinal canal. Unlike epidural anesthesia, spinal anesthesia does not involve a catheter and the agent will be directly lead to the necessary region. This will usually numb the area below the site of injection or sometimes above.
The patient may not be able to move his lower limbs until the effect of the agent is worn off and sometimes will experience a headache following the procedure. This can be treated effectively with a mild analgesic.
Commonest Spinal Anesthesia:
- Fentanyl
- Bupivacaine
- Lidocaine
The effect of these can last for 2 hours and might vary from person to person and the extent of numbness will depend on the type of drug used and the dose injected.
Using the already introduced cannula between the spinous processes of the L3/L4 vertebrae, the spinal needle is then introduced and punctuated within the subarachnoid space. Through this needle, local anesthetics, and other drugs may be injected.
What is Epidural Anesthesia
This is a type of regional anesthesia in which only a certain part of the body of the patient is made numb. The procedure will involve the insertion of a hollow needle along with a tiny and flexible catheter into the epidural space which is defined as a marginal area in between the spinal column and the outer membrane of the spinal cord.
Areas which can be numbed using an epidural include, chest, abdomen, pelvic area and limbs. Furthermore, epidurals are highly used during childbirth to reach an efficient pain-free delivery.
This can be very painful for certain patients and therefore, the skin area through which the needle is inserted will be anesthetized and made numb with the help a local anesthetic agent, prior to the procedure. The needle will be inserted right into the accurately identified space and removed afterward when the catheter is thoroughly passed through and located in the correct space.
The epidural anesthetic medication will then be injected into the catheter so that the areas above and below the point of injection will get completely numb. It is important to have the catheter fixed onto the back since it can be reused in case more anesthetizing agent is required.
The two major risks associated with Epidural anesthesia include,
- Puncturing of the Dura, which is the protective layer surrounding the brain and spinal cord.
- Damage to surrounding nerves which is a very rare complication
Difference Between Spinal and Epidural Anesthesia
Both spinal and epidural anesthesia belong to the category of regional anesthesia which is responsible for numbing only a certain part of the body.
As far as the major differences between these two types are concerned,
Location
Spinal anesthesia is usually injected right into the cerebospinal fluid.
Epidural anesthesia involves passing the medication into the epidural space.
Use of a Catheter
Spinal anesthesia does not use a catheter.
In Epidural anesthesia, the medication will be passed into the epidural space through a catheter.
Childbirth
Even though both these types can be used for lower limb and pelvic surgeries, epidural anesthesia is often used as an effective numbing agent for child delivery.
Image Courtesy:
“Epidural Anesthesia” By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia
“Prinzip der Spinal anaesthesia” By I, PhilippN (CC BY-SA 3.0) via Commons Wikimedia
