What Is Saddle Anesthesia?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 20 November 2014
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Saddle anesthesia, or caudal anesthesia, refers to numbness around the groin, across the buttocks and through the perineum, the flesh between the buttocks. When it occurs spontaneously, it can be a sign of damage to the spinal cord, and may be a symptom of a medical emergency. It can also be induced by an anesthesiologist for a medical procedure. In both cases, some neurological testing can be used to determine the extent of the loss of sensation.

Spontaneous development of saddle anesthesia is often associated with cauda equina syndrome. This medical condition occurs as a result of damage to the nerve roots at the base of the spinal cord. They are known as the “cauda equina” or “horse’s tail” because of their appearance, and most commonly experience injuries as a result of a herniated disc. If this condition is not treated, it can cause paralysis. Patients can also develop incontinence and other problems.

In addition to causing saddle anesthesia, this condition can contribute to weakness, incontinence, and poor coordination of the legs. A medical imaging study may reveal damage to the spinal cord, while a physical exam can provide more information about the specific nerve roots involved. The patient may need immediate surgery to decompress the spinal cord and prevent permanent damage. After surgery, recovery may involve resting along with physical therapy to redevelop strength and coordination while protecting the spine.

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The saddle block is an anesthesia technique care providers may recommend for some procedures around the groin area. One reason to use saddle anesthesia is in an episiotomy, where a doctor cuts into the perineum to facilitate delivery of a baby. This can be quite painful, and anesthesia is required to keep the patient comfortable. Anesthesiologists may recommend saddle anesthesia for other procedures involving the perineum, such as drainage of abscesses around the anus.

To perform a saddle block, the anesthesiologist carefully prepares the patient’s lower back, wiping it down with antiseptics to reduce the risk of infection. A needle can be used to numb the area before inserting a larger needle to numb the spinal cord. Pain signals will no longer move up the spine, allowing care providers to continue with a procedure. Typically the doctor recommends a brief waiting period and a check to make sure the anesthesia has taken effect before proceeding, to reduce the risk of causing pain and distress by starting while the patient still has sensation.

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anon951535
Post 4

I had a discectomy twice for L4-L5 first, then the second after two weeks for L5-S1 in 2005. Immediately after the first surgery I faced new problems like urine and stool retention, perineal and scrotal numbness involving the posterior part of my penis. I also have posterior thigh numbness. I urinate with abdominal pressure and have pain in my right distal leg. I am still on Diclofenac 100 mg twice a day. Any suggestions?

JackWhack
Post 3

My grandmother had a saddle block before having surgery on her hemorrhoids. It would have been an unbearably painful surgery without this.

kylee07drg
Post 2

I've had numbness in this area before, but I always knew why. It wasn't from some mysterious spinal condition.

I had just been riding on the back of a motorcycle for too long. If I sit on one for longer than an hour, my whole saddle area goes numb.

It is super uncomfortable to walk around once this happens. I feel all tingly and when the sensation starts to return, I feel sharp pains like needles.

StarJo
Post 1

A saddle block sounds both horrible and convenient! If the doctor were going to have to cut me down there so that I could give birth, I would be extremely grateful for the anesthesia.

I would probably freak out if I could see the big needle going into my spine. I would just shut my eyes and wait for the numbness.

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