Spinal and epidural anaesthesia both are numbing medicines that are used for various surgeries to relieve the pain of the patients. They have the same work but they have several differences as well. Their effect and usages are different.
Spinal vs Epidural Anaesthesia
The main difference between spinal and epidural anaesthesia is that they are given in different places. Epidural anaesthesia is implanted into the epidural space of the body and spinal anaesthesia is given directly in the dural sac of the spinal cord. Spinal anaesthesia gives instant relief.
Spiral anaesthesia is given on the fluid of the dural sac directly and it works immediately and numbs the pain. Only one dose is given at once and the effect lasts for an hour or two. It is not chosen for labour usually, as giving birth can last for way more than 2 hours.
Epidural anaesthesia is another numbing medicine that is used to ease pain. This anaesthesia takes some time to start its action but it prevails for a long time and keeps on working. It takes time to work as is it given on the epidural and it takes to some time to reach the sac where it starts to work.
Comparison Table Between Spinal and Epidural Anaesthesia
| Parameters of Comparison | Spinal Anaesthesia | Epidural Anaesthesia |
| Definition | It is a numbing medicine that is given on the dural sac of the spinal cord. | It is a numbing medicine that is given on the epidural. |
| Given area | It is given directly in the dural sac of the spinal cord. | It is given on the outside of the sac. |
| Time of action | It starts to work instantly and relieves pain. | It takes 10-15 minutes to start working and relieves pain. |
| Effectiveness | The effect stays for around 2 hours. | Its effect stays for a long time. |
| Dose | One single shot is given with this, that works for 1-2 hours. | It is given with an attached catheter that flows the anaesthesia to the body as needed. |
What is Spinal Anaesthesia?
Spinal anaesthesia is also known as a spinal block. This anaesthesia is given just once into the dural sac. This relieves the pain instantly and lasts for around 2 hours. The spinal cord and the nerves presented in a sac is filled with a kind of fluid, this fluid is called cerebrospinal fluid. The space around this sac is called the epidural space.
Spinal anaesthesia injection is inserted directly into the fluid of the sac and as a result, it works immediately. As it is given directly into the fluids, less amount of dose can be given. But it is given as a single shot and that is why it does not work for a long time. In the case of long surgery, this is not the ideal anaesthesia.
Once the spinal anaesthesia is given an immediate sensation, tingling and warmth can be felt, due to this patients stretch up their legs and anaesthesia starts its work. Soon the lower body becomes numb and heavy. The effect, the patient’s breathing, blood pressure and heartbeat are constantly subjected to monitor.
What is Epidural Anaesthesia?
In epidurals anaesthesia, the needle is inserted into the lower back area of the body so that it can reach to epidural space easily. This injection is given in the space that is outside the sac or epidural space. It needs some time to take action, as it needs time to reach the epidural area, generally, it takes around 10 minutes and in 10-15 minutes it starts its action and relieves pain to give comfort.
Once this process is completed, a catheter gets threaded with the help of a needle and once the needle is removed, the catheter gets taped to the back of the body and keeps it in place. That catheter contains anaesthesia that flows on the body either continuously or periodically, according to the need. This anaesthesia works for a long period of time as it has a continuous flow of anaesthesia.
This anaesthesia is regarded as ideal for childbirth as it provides good pain relief without numbing the legs completely, in this way the patient is able to move their legs and push the baby.
Main Differences Between Spinal and Epidural Anaesthesia
- Spinal anaesthesia is a numbing medicine that is given on the fluid of the dural sac directly of the spinal cord. But epidural anaesthesia is a numbing medicine that is given on the outside of the sac.
- Spinal anaesthesia is very fast to give relief and restrict pain, it starts showing effect as soon as it is given while on the other hand, epidural anaesthesia takes 10-15 minutes to start working and relieves pain.
- Spinal anaesthesia is given in the fluid of the dural sac of the spinal cord whereas epidural anaesthesia is given on the outside of the sac.
- On one hand, the effect of spinal anaesthesia lasts for around 2 hours but on the other hand, epidural anaesthesia’s effect dwells for a long time.
- One single shot of spinal anaesthesia is given in one go whereas epidural anaesthesia is given with an attached catheter, from where the dose of anaesthesia keeps on flowing to the body.
Conclusion
Both of the anaesthesia have the same effect, both effectively numb a large area of the body. But their time and duration of effect are different from each other. One is chosen between the two depending on the need for the surgery. Mostly epidural anaesthesia is chosen for childbirth as it has a long-lasting effect. But spinal anaesthesia starts to work as soon as the injection is given.
In some cases, a combination of spinal-epidural is given, in this way the advantages of each anaesthesia is utilised. In this case, an epidural catheter is inserted after spinal injection. Here spinal anaesthesia gives instant relief and it is maintained by epidural anaesthesia.
References
- https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003765.pub2/abstract
- https://bjanaesthesia.org/article/S0007-0912(17)36768-5/fulltext