What is a spinal?

A ‘spinal’ is an injection of local anaesthetic in the lower back into the spinal fluid space, where the nerves supplying the legs and lower abdomen run. This causes complete weakness and numbness to the part of your body being operated on for the next 2-4 hours.


Why should I have an spinal?

  • Better pain control: drugs can be injected into the spinal space which provide excellent pain relief, with minimal side effects when compared to oral or intravenous pain relief.
  • Safety: many operations of the lower abdomen and legs can be performed purely under spinal (with sedation if required). This avoids exposure of your lungs and brain to the anaesthetic, which has clear safety benefits for certain patients.


How is a spinal done?

I will position you sitting up over the side of your bed with your back flexed. I will clean your skin, and inject local anaesthetic to numb the skin around the spinal area. While you keep very still, and using a special needle, I find the spinal fluid space and administer local anaesthetic. This usually takes 2-5 minutes for full effect. If anything bothers you while the spinal is being done it is important to let me know.


Will the spinal work?

Spinal blocks work very well. They have a high success rate (>95%). I always test your spinal and ensure you are comfortable. If it is not working well, another spinal may be performed or we may decide to give you another form of anaesthesia.

A common misconception regarding spinals is that you have to be awake during surgery. In addition to your spinal, I can provide you with sedation, which renders most people sleepy and unaware of their surroundings during the surgery.


Are there any side effects or complications from spinals?

The side effects include:

  • Decrease in blood pressure easily treated with medications.
  • Weakness of the legs which means you will have to remain in bed.
  • Inability to use your bladder which will necessitate a urinary catheter.
  • Itchiness.

Complications can be classified as follows:

  • Minor: < 1% risk of severe headache lasting several days.
  • Major: Extremely rare but serious risks which occur < 1:50,000 cases.
    • Permanent nerve damage due to abscess (infection) or haematoma (collection of blood).
    • Severe allergy to the spinal medication.