REGIONAL ANESTHESIA is a time-limited state of reversible termination of the sense of pain due to the application of various physical and chemical agents in the vicinity of a nerve or nerve plexus. It is also known as local anesthesia. Local anesthetics applied locally cause a block in the conduction of the nerve impulses through the nervous system. Spinal and epidural anesthesia are the most commonly used techniques in surgery and in the treatment of chronic pain. Spinal and epidural anesthesia cause profound analgesia and muscle relaxation.
SPINAL ANESTHESIA is a central block resulting from the direct action of the local anesthetic encapsulated by means of a lumbar puncture on the spinal nerves. For performing the spinal puncture, the patient is placed in a sitting or supine position with protrusion of the spine (kyphosis) towards the anesthesiologist. This position provides maximum opening of the spaces between the vertebrae. The place of performance is the bottom of the spine. The time of binding of the anesthetic to the spinal nerves is from 5 to 15 minutes.
EPIDURAL ANESTHESIA is an input of a local anesthetic into the epidural space. It is widely used in surgery, obstetrics and pain treatment. Epidural anesthesia is performed in an operating room. The position for performance of the procedure is the same as in spinal anesthesia. The needles are thicker and their top is tilted upwards. A so called epidural catheter is placed through which the anesthetic is continuously given. Before a full dose is administered, a test dose is given in order to confirm that it is a matter of the epidural space. About 3-4 ml of the anesthetic is applied. If by mistake the catheter is in the subarachnoid space, a complete block would occur (both motor and sensitive). This type of anesthesia can be independent or combined with spinal or general anesthesia.