You and Your Anaesthetic

This page aims to offer you an introduction to anaesthesia. There are wide differences in how much information people want. Only you can know how much you want to know. We offer some information here and at the end we suggest where you can find out more. Always remember that your anaesethetist can answer specific questions for you and help you to determine your best choice of anaesthesia based on what your personal health status, the surgery you are having and the experience and knowledge of your anaesthetist. Produced by Dr Michelle Reichman whilst she was training at Haughton Thornley Medical Centres.

2. REGIONAL ANAESTHETICS

Regional anaesthesia can be used for operations on larger or deeper parts of the body. Local anaesthetic drugs are injected near to the bundles of nerves which carry signals from that area of the body to the brain.  The most common regional anaesthetics are spinal and epidural anaesthetics.

Epidural anaesthetic
What is an epidural?
An epidural anaesthetic involves injecting drugs into an area called the epidural space near the spinal cord. The drugs numb your nerves to give pain relief in certain areas of your body. Epidurals can be used either on their own while you are awake, or together with sedation or general anaesthesia. They can also be used after your operation to give effective pain relief.
 
What does the procedure involve?
Your anaesthetist will insert an epidural catheter using a needle (see figure 1). They will then inject a small amount of drug through the catheter to check the position. Once they have completed this check, they will give more of the drug until the epidural is working properly. The effect of the epidural can be varied by changing the type and amount of drug given.

What complications can happen?
• Failure of the epidural
• Low blood pressure
• Headache
• Respiratory depression
• Itching
• Bladder-emptying problems
• Leg weakness
• Backache
• Infection around the spine
• Seizures, due to the local anaesthetics
• Short-term nerve injury
• Blood clot around the spine
• Damage to nerves
• Paralysis

Spinal anaesthetic
What is a spinal anaesthetic?
A spinal anaesthetic involves injecting drugs into an area called the subarachnoid space near the spinal cord. The drugs numb your nerves to give pain relief in certain areas of your body. Spinals are single injections which take only a few minutes to work and last about two hours. They cannot be topped up to make them work longer.  Spinals can be used either on their own while you are awake, or in combination with sedation or general anaesthesia.

What does the procedure involve?
Your anaesthetist will insert the needle, inject drugs through it and then remove the needle (see figure 2).
It should not be painful, although it can be uncomfortable.
A spinal anaesthetic usually lasts between one to three hours. The anaesthetist will put enough drugs through the needle to make sure that it lasts longer than the expected length of the operation.

What complications can happen?
• Failure of the spinal
• Low blood pressure
• Headache
• Itching
• Bladder-emptying problems
• Backache
• Loss or change of hearing
• Nerve damage

For further information from NHS Choices about epidural anaesthesia, click here

For further information please click on one of the links below:
Introduction to anaesthesia
General anaesthesia
Local anaesthetic
Pain relief after surgery

Further information from the Royal College of Anaesthetists for patients is available by clicking here

The Royal College of Anaesthetists have also created a series of leaflets on the following subjects that you can download from here:
Anaesthesia explained
You and your anaesthetic
Your child's general anaesthetic
Headache after epidural or spinal anaesthetic
Your spinal anaesthetic
Anaesthetic choices for hip or knee replacement
Epidurals for pain relief after surgery
Your child's general anaesthetic for dental treatment
Your tonsillectomy as day surgery
Local anaesthesia for eye surgery
Your anaesthetic for aortic surgery

For further information:
Royal College of Anaesthetists at www.rcoa.ac.uk
Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland at www.youranaesthetic.info
NHS smoking helpline on 0800 169 0 169 and at www.gosmokefree.co.uk
www.eatwell.gov.uk – for advice on maintaining a healthy weight
www.eidoactive.co.uk – for information on how exercise can help you
www.aboutmyhealth.org - for support and information you can trust

Who supplies the information for this website?
There are many sources of information now available to us all on the internet, what we have endeavoured to do with this site is to bring together reliable sources of information from NHS Choices (National Health Service), BBC Health as well as links to patient and carer organisations, charities and others that we feel can be trusted. Please refer to the terms and conditions of use and ALWAYS CONSULT A DOCTOR OR OTHER HEALTHCARE PROFESSIONAL IF YOU REQUIRE MEDICAL HELP

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