Complications

Depending on the amount of anesthesia, discomfort may occur from time to time after the operation or, possibly rarely, during the operation. The medication can cause a reduction in the activity of the cardiovascular system, in this context it can lead to a decrease in blood pressure and heartbeat. Remedial action in this situation can be taken by medication that stabilizes and strengthens the circulation, as well as the administration of fluids that help to stabilize the circulation.

Spinal cord anaesthesia at lung level can lead to a reduction in respiratory function, which in turn leads to reduced depth of breath with insufficient oxygen uptake and carbon dioxide release. This can be remedied by administering oxygen via a nasal probe, and if the respiratory situation continues to be poor, ventilation must be considered. Rarely does puncture of the spinal canal develop negative pressure, which can cause headaches.

In such cases, it is helpful to lie flat in order to reduce the tension on the puncture site and the meninges as such. If the spinal cord is injured during the puncture of the spinal canal, there may be failures associated with numbness or muscle paralysis. These symptoms can be regressive and self-limiting. If a hematoma forms in the spinal canal, it must be surgically removed.These complications are very rare.

Side effects and risks

As with all medical procedures, complications and side effects can occur with spinal cord anaesthesia. Spinal or epidural anaesthesia can fail unexpectedly and thus possibly cause pain or not be effective properly. In addition, the vessels of the lower body hemispheres are dilated due to the elimination of the corresponding nerves, which can lead to a significant drop in blood pressure.

This situation can be remedied by medication to stabilize and strengthen the circulation, as well as the administration of fluids, which help to stabilize the circulation. Spinal cord anaesthesia at the level of the lungs can lead to a corresponding reduction in respiratory function, which in turn leads to reduced depth of breath with insufficient oxygen uptake and carbon dioxide release. This can be remedied by administering oxygen via a nasal probe, and if the respiratory situation continues to be poor, ventilation must be considered.

A typical side effect is also the so-called post-spinal headache, which, depending on the procedure, can affect more or less patients a few days after the procedure. In this case, it is helpful to lie flat to reduce the tension on the puncture site and the meninges as such, possible intake of painkilling medication and an ample supply of fluids can improve the symptoms. A risk dreaded by many patients – spinal cord injury – occurs extremely rarely.

If the spinal cord is injured during the puncture of the spinal canal, it can lead to loss of function, accompanied by numbness or muscle paralysis. These symptoms can be regressive and self-limiting. Infections or bruising of the puncture site are also rare, as is the systemic – i.e. the effect of the local anesthetic affecting the entire body.

If a hematoma forms in the spinal canal, it must be surgically removed. Finally, however, considering all possible risks, it must be noted that through continuous monitoring by the anesthetist and thorough care of the puncture site, most side effects can be quickly recognized and treated, or even prevented from the outset. This makes spinal cord anaesthesia as a whole a very safe and advantageous anaesthetic procedure.

Unfortunately, one of the typical side effects of spinal cord anaesthesia is the so-called post-spinal or post-puncture headache. The unpleasant complication is probably caused by a loss of cerebral fluid (liquor) due to a leak in the spinal cord skin, which has occurred during the course of spinal anaesthesia. Since not as much cerebrospinal fluid can be replicated as is lost, a negative pressure is created in the cerebrospinal fluid space, in which our brain and spinal cord float.

This results in the typical headaches, which get better when lying down and get worse in an upright position. Bed rest and an adequate fluid intake are recommended for the treatment of post-spinal headache. Below this, the symptoms usually improve within a few days.

If this is not the case, it can be assumed that the leak has not closed by itself. In this case, a so-called blood patch consisting of a few milliliters of the patient’s own blood can be inserted into the puncture site. The blood clotting here seals the liquor leak, so that the headaches will soon subside.