THE DIFFERENCE BETWEEN SPINAL AND EPIDURAL BLOCKS
Written by Caroline Meyer
You may find people refer to Spinal block, regional anaesthesia and epidural blocks as if they are the same thing. This is not the case. Epidural blocks and spinal blocks are different from each other but both full under regional anaesthesia.
With a spinal block, a much smaller needle is used than that for an epidural block. The medication is injected into the cerebrospinal fluid. This is the substance that bathes the entire spinal cord. The needle is used to create a tiny hole in the tissue which encases the spinal cord, known as the dura. The medication is then carried throughout the spinal fluid, meaning a lot less is needed. With an epidural, the pain relieving medication is delivered outside of the dura, into the epidural space. This is what gives this anaesthesia type its name. This means that a lot more medication is needed as the analgesic effect is absorbed through the tissues and not the spinal fluid. Occasionally the dura may be punctured during an epidural block. This is known as a dural puncture.
During a spinal block, there is only one chance to deliver the anaesthesia correctly as it consists of a single injection of the medications into the cerebrospinal fluid. When an epidural is administered, a catheter is placed in the epidural space. This means that medication can be administered at any time while the catheter remains in place. This also allows for a much longer period of anaesthesia than with a spinal block.
While an epidural is commonly used for pain relief during the birth process, it is often used in other types of surgery as well. It may also be used to relieve pain after surgery or as a way of managing chronic pain. It is recommended for use where possible as a lower dose of medication is needed to get the desired effect and there are fewer side effects than experienced with many opioid pain relievers. Administered correctly, an epidural can offer long-lasting relief from pain while still allowing you to stay mobile and alert.
EPIDURAL NERVE BLOCKS
An epidural block (aka “epidural”) or epidural nerve block is used to prevent pain signals from travelling to your brain and consists of numbing the spinal nerves. A thin, flexible tube is place near your spine and delivers the medication via the tissue in the area to prevent feeling of pain during surgery or labour. The procedure to implant the catheter is a little tricky, but once in place, the medication starts to work within 10 to 20 minutes. You can still feel touch and pressure but no pain. You can even walk around with assistance if you wanted to as you are numb but can still move without too much problem.
Some of the side effects of an epidural nerve block can include headaches, a drop in blood pressure and problems urinating. Very rare complications can include infection, nerve damage and bleeding in the epidural space. Epidurals can also be done using medications such as steroids for inflammation and pain relief in certain areas of the body such as back, arms, neck and legs.
The epidural process is different when targeting a specific area. A dye is used along with a special type of X-ray to ensure the epidural needle is inserted in to the correct location to target the specific pain. For an epidural during labour, the anaesthesiologist is generally well versed on where to insert the catheter to numb the entire lower region of the body.
Conditions other than labour and surgery that are treated with an epidural nerve block include spinal pain, pinched nerves, spinal stenosis and herniated discs. The actual process of inserting the catheter takes around 10 to 15 minutes and relief is felt within 10 to 15 minutes after the medication is administered, although it may differ for some people. The duration of the pain relief can also differ from person to person. Epidurals work for most people, but not for everyone. For people that require epidurals for chronic pain, the benefits of this type of treatment can last for months. An epidural can also be used to try and located a source of pain. The epidural will be used to target specific nerves and when you find pain relief, the doctor knows exactly where the pain originates.
An epidural is the more likely form of anaesthesia that is offered during labour and for caesarean surgery to allow you to stay alert and pain free and able to fully experience the joy of bringing your little one in to the world.