spinal analgesia
Last reviewed 01/2018
Spinal analgesia is the suppression of pain and other sensation in a part of the body by injection of a analgesic drug or local anaesthetic into the space around the spinal cord. Two forms are commonly employed: epidural and subarachnoid routes. There is some confusion in the terminology - spinal analgesia is commonly taken to mean the subarachnoid route, and extradural is another term for epidural.
This technique is commonly used post-operatively and in complications of the third stage of labour.
Advantages:
- effective, with rapid onset
- minimal drug dose needed
- hypotension due to sympathetic blockade reduces the risk of haemorrhage
- muscular relaxation often permits surgery without disrupting spontaneous ventilation
Disadvantages:
- "one-shot" technique unless catheter infusion
- risk profound hypotension
- post-spinal headache in 15% of cases; does not occur with epidural analgesia
- very rarely, risk of meningeal infection