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A spinal block is a type of short anesthetic treatment that may completely reduce sensation from the point of injection in the spine, at just above the hips, down to the feet. Doctors use this procedure as a means of reducing pain for chronic medical conditions or lower back injuries. Alternately, a block might be used as main anesthesia prior to medical procedures that involve surgical elements.
One area of confusion for most people is how this procedure is different from an epidural. Many people also have epidurals prior to significant surgeries including a cesarean section, or during other surgeries or procedures that involve the lower half of the body. They’re commonly used as pain control during childbirth, and may be used for more consistent pain relief of severe pain conditions at or below the hips.
The principal difference between a spinal block and an epidural is fairly easily explained. The block is a single shot and a one-time administration of anesthetic medication. The epidural places a direct line into the spine through which medication can be fed. Amounts given can be less or more depending on need and time elements of a procedure. In contrast, the spinal block medicine will work as long as it lasts, which is about one to two hours. Should more medication be required, another block would be necessary.
This last factor is one that might be taken into account if length of pain condition or difficulty of a procedure is unknown. For instance, many women close to getting ready to deliver a baby might opt for a spinal block instead of having a full epidural. Those who have hours to go before delivery could be made much more comfortable with an epidural and they avoid repeated injections into the spine.
As for risk factors, spinal block and epidural share some features. In both procedures there is risk for infection and chance that the dura will pierced, which can result in development of headaches that may come and go for months. Generally, greater potential problems result from an epidural including allergic reaction, though this may also occur to any anesthetic in a spinal block, back troubles, damage to nerves, and occasionally fever.
Some patients are given the option of having a spinal block or an epidural, and since both can have advantages and disadvantages, one good way to help determine best treatment is to talk with an anesthesiologist about the choices. Anesthesiologists may have a preference but they’ll also give detailed information about risks versus benefits of each procedure. Generally the epidural is favored for any surgical or medical procedures that might exceed a couple of hours in length. Blocks may be preferable as temporary relief or during surgeries that are very short in duration.
I had to have a scheduled c-section with one of my pregnancies. My doctor and I decided that a spinal block for my c-section was the best way to go. There are studies that show higher rates of maternal mortality when women use the general anesthesia option.
I was awake for the procedure. I really appreciated that the spinal block helped me manage my postoperative pain. My baby didn’t suffer any ill effects which was an even better benefit. I did have some back pain, but I’m pretty sure I would have been just as sore anyway.
A friend of mine has degenerating discs in her back. The doctors and specialists were trying to find alternatives to surgery to control her pain. She received spinal nerve blocks on two separate occasions. Unfortunately, they did not give adequate pain relief for her.
In her case, I think obesity was a factor. My best friend is an RN. She was explaining to me that morbid obesity makes it much harder for the anesthesiologist to get the spinal block in the right place.
Often, a higher dose of the medication is required in these situations. That creates additional dangers for the patient, including reduced respiratory function.
My friend with the discs going bad ended up having to have surgery to fuse them.