A spinal block is a regional anesthesia where medication is administered into the fluid surrounding the spinal cord, numbing a specific body area. Its purpose is to provide pain relief for surgical procedures or childbirth. While some sensations and discomfort are expected, a spinal block is typically not a severely painful procedure, thanks to local anesthetics.
What to Expect During the Procedure
The procedure begins with careful positioning, often with the patient sitting up or curled on their side, and the skin on the back is cleaned. The first sensation is usually a brief, sharp sting or pinch from a local anesthetic injection. This initial injection numbs the skin and underlying tissues for the spinal needle insertion.
After the local anesthetic takes effect, the medical team proceeds with the spinal needle insertion. Patients commonly describe feeling pressure, pushing, or a dull ache as the spinal needle is advanced. If any sharp pain or an electric shock sensation occurs in the legs or other areas, communicate this immediately to the medical team, as the needle may need a slight repositioning to avoid a nerve.
Once the needle is correctly positioned, the anesthetic medication is administered, which may cause a cool sensation or no sensation as it spreads. The numbing effect begins within five to ten minutes, with sensations of warmth and tingling often preceding complete numbness and weakness in the legs.
Minimizing Discomfort During the Procedure
Medical professionals play a significant role in reducing discomfort during a spinal block. The skill and experience of the anesthesiologist are important for precise procedure performance. Local anesthetics are routinely used to numb the skin before the spinal needle is introduced, making the initial part more tolerable. Mild intravenous sedatives can also be offered to help patients relax and reduce anxiety, which can lessen the perception of discomfort.
Patients also have an active role in minimizing their own discomfort. Remaining as still as possible during the injection is important for safety and effectiveness. Communicating any sensations, such as pressure, tingling, or sharp pain, to the medical team immediately allows for prompt adjustments. Following instructions from the medical team, such as breathing techniques, can also help manage apprehension during the process.
Potential Post-Procedure Discomfort
After a spinal block, mild soreness or tenderness at the injection site in the back is common. This discomfort is typically comparable to soreness after any injection and usually resolves within a day or two. This localized backache is a frequent side effect, often attributed to tissue trauma or temporary stretching of spinal ligaments.
A less common, but recognized, side effect is a post-dural puncture headache (PDPH). This specific type of headache can occur if there is a small leak of spinal fluid following the procedure. PDPH is characterized by a headache that worsens when sitting or standing and improves when lying down, sometimes accompanied by neck stiffness or changes in hearing.
It often resolves within a week or two, but treatments like bed rest, hydration, caffeine, and in some cases, an epidural blood patch, can provide relief. Other temporary sensations as the block wears off include numbness, tingling, or weakness in the legs, which are normal and typically resolve completely as sensation returns over a few hours.