Spinal anesthesia is a surgical procedure which involves injection of an analgesic or anesthetic drug into the spine to enable surgery to be performed in the region where the anesthetic has been injected. The pioneer in spinal anesthesia was Leonard Corning, an American neurosurgeon who performed spinal anesthesia using cocaine on a dog in 1885.
Subsequently, in the year 1898, August Bier conducted the first spinal anesthesia on a human being for which he used cocaine during a leg surgery. Today, spinal anesthesia is a regular surgical procedure. There are two types of spinal anesthesia – spinal and epidural.
An injection of a solution of local anesthetic is given into the subrarachnoid space. This blocks the transmission of impulses through the nerves in the region.
It may be recalled that there are three types of nerves – sensory, motor and autonomic. If the motor nerves are stimulated, they contract, resulting in paralysis of the muscles. The sensory nerves send sensations like sense of touch to and from the brain and the autonomic nerves control the heart rate, gut contraction, movement of blood vessels and so on. In spinal anesthesia, the sensory and autonomic nerves are blocked before the motor fibers. The result is that the patient is aware some activity, but pain is not felt with the commencement of surgery.
A Visit Prior to the Operation: The patient should be made psychologically ready for the experience by giving a detailed explanation about the procedure.
Check the Equipment: All instruments like needles, syringes, swabs and sterile gauze and antiseptics should be kept ready on a separate trolley.
Swab the Back: The patients back should be swabbed with antiseptic just before inserting the needle. Swabbing should be done in a radial direction away from the injection site.
Positioning the Needle: The needle must be inserted until the cerebrospinal fluid appears. The syringe containing the anesthetic is then attached and the required dose is injected.
The person giving anesthesia must be skilled and experienced for the effective anesthesia treatment before the surgery.
Doctors: Doctors should have successfully completed the ACGME or AoA with an accreditation in residency in Anesthesiology. It should be within the eligibility period of 5 years. Additional documents of previous hospitals may be required to be produced.
Nurses: This is a specialized nurse known as nurse anesthetist. In the US, a Certified Registered Nurse Anesthetist (CRNA) would necessarily have to be an advance practice registered nurse (APRN) who will be a graduate in the relevant field.