The performance of a spinal anaesthesia is comparatively low risk and low side effects. In the days following the SPA, headaches may occur (so-called post-spinal headaches). This is caused by the not always avoidable loss of cerebrospinal fluid and is always easy to treat.
Furthermore, it can lead to bladder voiding disorders if the effect of the spinal anaesthesia is not yet completely eliminated. If these symptoms occur, however, they disappear within a few hours. Furthermore it can come to an infection of the puncture site.
The following complications should be mentioned for the sake of completeness, but are extremely rare: If a larger vein is punctured during the puncture, the escaping blood can compress the spinal cord and in the worst case lead to permanent damage. However, this risk can be minimized considerably by first checking whether the blood has the normal ability to clot when it exits a vessel
- Slowing of the heartbeat, drop in blood pressure or paralysis of breathing. However, these complications can be treated well by the use of emergency medications.
- Damage to the spinal cord by the puncture needle
- Allergic reactions to the local anesthetic
To minimize the risk of spinal cord compression due to blood leaking from a vein, the coagulation ability of the blood must be controlled.
This ability is limited, among other things, after taking anticoagulant medication. In a preliminary consultation with the anesthesiologist, it can be clarified from when these drugs may no longer be taken. The following times are given as a rough guide: It should also be noted that this information does not refer exclusively to medication prescribed by the doctor: Taking painkillers on your own responsibility in the days before the operation can also considerably increase the risk of bleeding.
- Unfractionated heparin must be discontinued 4 hours before an SPA (spinal anesthesia), low molecular weight heparin already 12 hours before.
- Non-steroidal anti-inflammatory drugs (e.g. Ibuprofen, Diclofenac, etc.) may be taken 24 hours before the SPA (spinal anesthesia)
- There must be at least 3 days between the intake of acetylsalicylic acid (Aspirin) at single doses greater than 100mg per day and a SPA
- Stop taking clopidogrel (Plavix®) 10 days before
- Marcumar or warfarin must first be converted to heparin
Spinal anesthesia should not be performed during In individual cases, however, the anaesthetist will decide in the clarification discussion whether there are any reservations against the performance of an SPA (spinal anaesthesia).
- Blood coagulation disorders
- Infections/skin diseases in the area of the injection site
- Severe cardiovascular diseases
- Anemia (so-called hypovolaemia)
- Deep positioning of the head during surgery
- Cerebral pressure elevation
