What is the difference to spinal anesthesia?
Both methods belong to the regional anaesthesia methods close to the spinal cord and can be used “only” as partial anaesthesia or in combination with general anaesthesia. The main difference between a peridural or epidural anaesthesia (PDA) and a spinal anaesthesia is the puncture site (the injection site). In the case of spinal anesthesia, the puncture is necessarily performed in the area of the lower lumbar spine between two vertebrae.
This is necessary because the compact spinal cord extends to the transition between the first and second lumbar vertebrae. In order not to injure this, the injection is performed between the third and fourth or fourth and fifth lumbar vertebrae. In this area there is no longer a compact spinal cord, but only the roots of the spinal nerves.
These thread-like structures are surrounded by the so-called cerebrospinal fluid (cerebrospinal fluid/spinal fluid). When injected into this region (spinal anesthesia), these nerve roots are not injured, since they move in the cerebrospinal fluid and are not injured by the needle, since they recede during the puncture due to the changed pressure conditions. In epidural or epidural anaesthesia, on the other hand, the injection needle is “only” advanced to between the two blades of the hard meninges in the area of the spinal column.
This allows the anaesthetic to be injected directly at the level of the area to be anaesthetised. In contrast to spinal anaesthesia, epidural anaesthesia often involves the insertion and fixation of a small catheter.In addition to these, medication can also be given after the operation to relieve pain. An important field of application of epidural anaesthesia is birth – both natural birth and birth by caesarean section.
The puncture site is chosen in the lower lumbar region, i.e. approximately at the height at which slim people can feel the upper edge of their pelvic bones. Epidural anesthesia is only applied when the birth process has been clearly initiated. In principle, expectant mothers are recommended to give birth without epidural anesthesia if possible.
However, if the woman expressly wishes to have epidural anesthesia, this will be performed as a matter of principle. The local anesthetic is usually dosed in such a way that a noticeable but not complete pain reduction is achieved. This has the advantage that the contractions are not completely paralyzed, which would complicate and prolong the birth process. The advantages of epidural anaesthesia during childbirth include not only effective pain reduction but also the fact that the mother can witness the birth during a caesarean section, as opposed to general anaesthesia. Epidural anaesthesia is also advantageous if a caesarean section or the use of a suction cup or forceps should become necessary during the birth process, since the anaesthesia that has already been administered means that it can be started immediately.
