One third of all children in Germany are born by caesarean section. This is a special situation, as the choice of anesthetic method must take into account both the effects on the mother and the effects on the child. In addition to general anesthesia, a caesarean section can also be performed under regional anesthesia close to the spinal cord.
These include epidural anaesthesia and spinal anaesthesia. Both are considered to be safe anaesthetic procedures that ensure optimal pain elimination during the caesarean section. In spinal anaesthesia, the lower half of the body is anaesthetised by injecting anaesthetic into the spinal canal (spinal canal).
Thus, the mother is conscious during the caesarean section, but feels no pain and cannot move in the lower half of the body. Sometimes the sensation of pressure is partially retained, so that it is felt that something is being done, but no pain is felt. In order to dampen the consciousness somewhat, a sedative can be taken. Many clinics offer mothers the option of listening to music through headphones during the procedure to protect themselves from the noise in the operating room.
Procedure of spinal anesthesia
In the canal that runs inside the spine, the spinal canal, there is nerve fluid, the spinal cord, as well as the nerve fibers emanating from the spinal cord. The spinal cord ends approximately at the level of the first lumbar vertebral body, below which only nerve fibers run. In order not to injure the spinal cord, a spinal anesthesia is performed between the 3rd and 4th lumbar vertebrae or between the 4th and 5th lumbar vertebrae.
It is best for the mother to sit and make a hunchback (“cat’s hump”), alternatively the spinal anaesthesia can also be performed in a lateral position. In this case a local anesthesia is performed first. Then a thin needle is inserted into the space between two vertebral bodies through the spinal cord skin (dura).
If the needle hits nerve fibers, these are able to avoid the needle, so that normally no injuries occur. As an additional precaution, the tips of the special needles are rounded. The anaesthetic is now injected into the space filled with nerve fluid.
Due to special characteristics of the anesthetic used, the body position and the insertion height, it is mainly distributed in the lower part of the spinal canal, so that only the lower half of the body is affected by the anesthesia. The injection may cause immediate tingling or heavy legs. Immediately afterwards the needle is pulled out again. One can imagine that the nerves that conduct the pain are washed around by painkillers, thus blocking the transmission of pain. The effect of spinal anaesthesia sets in quickly and lasts for about 3-4 hours.
