Dosage
There is no uniform dosage for spinal anesthesia. This is because every person reacts differently to the medication. This can be due to different physical stature or individual reaction patterns.
However, anesthesiologists are very anxious to keep the dosage as low as possible to counteract dangerous side effects. The most commonly used local anesthetics are : In addition to local anesthetics, opioids are still given today. The reason for this is that with a lower dosage of local anesthetics a longer lasting painlessness can still be achieved. Typical opioids for spinal anesthesia are :
- Bupivacaine (4-20 mg)
- Lidocaine (50-75 mg)
- Ropivacaine (10-15 mg)
- Fentanyl (20-25 μg)
- Sufentanil (2.5-10 μg)
Are there alternatives to spinal anesthesia?
Spinal anesthesia vs. PDA
In order to compare both forms of anaesthesia, one must consider the procedure and the desired effect. Both procedures have in common that the patient is still awake in contrast to a general anaesthetic. This has the advantage that the dangerous risks of a general anaesthetic can be avoided and that the patient can cooperate more easily.
A spinal anaesthesia is indicated for lighter operations in the lower half of the body. The advantage of spinal anesthesia is that the patient does not feel any pain locally after such an anesthesia and that his muscles cannot contract arbitrarily. This makes the operation much easier and reduces the risk of injury to the patient.
Epidural anesthesia, on the other hand, is a common tool in pain therapy. Depending on the dosage of the anesthetic, the degree of anesthesia can be influenced. Thus, at low concentrations of the anesthetic, mainly thin nerve fibers are blocked, which are responsible for the transmission of pain.
Only at higher dosages can the physician achieve a temporary paralysis of the musculature with this anaesthetic technique. The reason for this is that motor nerve fibers are much thicker than sensory ones. The procedure itself also differs between spinal anaesthesia and epidural anaesthesia.
In spinal anaesthesia, the anaesthetic is injected into the liquor. The cerebrospinal fluid surrounds all nerve fibers of the spinal cord, so that the anesthetic can be distributed quickly and the effect begins to take effect accordingly. This can be done in just a few minutes.
While in a spinal anaesthesia, the hard meninges (dura mater) have to be punctured to get to the liquor, in an epidural anaesthesia the anaesthetist gives the anaesthetic in the so-called epidural space. This surrounds the dura mater and contains mainly blood vessels. In contrast to spinal anaesthesia, the anaesthetic reaches the nerve fibers much more slowly, so that the desired effect is delayed. As a rule, the time span is no longer than 15 minutes. In addition, the doctor rarely achieves paralysis of the lower extremities, as this effect only occurs with more highly concentrated anaesthetics.
