Duration of spinal anesthesia
If performed routinely, spinal anesthesia only takes a few minutes. The effect of the anesthesia starts immediately after the injection of the local anesthetic and possibly an opioid, and is first noticeable by a feeling of warmth in the legs and buttocks. The duration of the spinal anaesthesia itself is primarily dependent on the choice of medication that is injected into the cerebrospinal fluid space where the spinal cord and spinal nerves are located. These in turn depend on the duration of the procedure, in which framework the spinal anesthesia is performed and can be varied. The anaesthetist can thus anaesthetize the relevant parts of the body for between 1.5 and over 3 hours.
Sobriety
Sobriety of the patient is an important prerequisite for performing spinal anesthesia. If the patient has had something to eat 6 hours before the procedure, the doctor should refrain from spinal anesthesia in any case. The reason for this is that complications can always occur during spinal anesthesia and the patient must be given an anesthetic.
During anesthesia, some bodily functions are shut down, including peristalsis in the digestive tract. In addition, the sphincter muscle between the stomach and esophagus is flaccid, so that stomach contents can return to the esophagus while lying down. There the stomach acid can cause inflammation.
Furthermore, the gastric juice can flow through the esophagus into the trachea. Since the patient cannot cough during anesthesia, this body’s own protective reflex is missing, so that the corrosive stomach acid and the leftovers can easily reach the lungs.Here too, the low pH value of the acid causes inflammation. In fasting patients, such post-narcotic pneumonia occurs only in one in 10,000 cases. In patients who ate or smoked before the anaesthesia, the probability increases many times over.
Do I need a bladder catheter?
Whether a bladder catheter has to be placed during spinal anesthesia depends mainly on the planned procedure and the habits of the physicians. For example, the placement of a bladder catheter is very common in caesarean sections, whereas a catheter is often unnecessary in orthopaedic or trauma surgery on the lower extremity. In any case, the bladder catheter will only be placed after the effect of spinal anesthesia has set in, so that hardly anything will be felt from the device itself. A complication of the spinal anaesthesia is a special case – in some cases urinary retention can be a side effect of the anaesthesia. Although this is usually reversible within a few hours to a few days, the temporary application of an indwelling catheter is necessary to enable the bladder to be emptied.
