Difference between spinal anesthesia and epidural anesthesia

Spinal anesthesia and epidural anesthesia belong to spinal anesthesia, a kind of local anesthesia

Epidural anaesthesia is the injection of medication into the epidural space (the potential space between the dura and the ligamentum flavum), and the diffused local anesthetic is passed through the space through the intervertebral foramen. Nerve root anesthesia. The dosage is 5 to 10 times larger than that of spinal anesthesia, the onset is slower (15 to 20 minutes), there is no damage to the dura, and it does not cause headaches after anesthesia. The epidural space is not communicated with the cranial cavity, and the injection level can be as high as the cervical spine, without paralyzing the life center of the medulla oblongata. If a catheter is placed, repeated injections can prolong the duration of anesthesia. Epidural anesthesia can anesthetize the sympathetic nerves, leading to peripheral vasodilation and myocardial depression, resulting in a drop in blood pressure.

Subarachnoid anaesthesia (spinal anaesthesia) is the injection of local anesthetic into the subarachnoid space (the solid space between the arachnoid and pia mater and filled with cerebrospinal fluid) through the lumbar intervertebral space to block the Because this cavity is connected with the ventricle, the excessive rise of the anesthesia level will lead to paralysis of the life center of the medulla, resulting in cardiac and respiratory arrest. During spinal anesthesia, because the sympathetic nerve is blocked, it is often accompanied by a drop in blood pressure, which can be prevented by ephedrine. In addition, because the dura is punctured, the cerebrospinal fluid leaks, resulting in a decrease in pressure, which is easy to cause headaches after anesthesia. The specific gravity of the liquid medicine and the patient's position will affect the level of the liquid medicine. If the drug is dissolved in the released cerebrospinal fluid, the specific gravity is higher than that of the cerebrospinal fluid. Dissolved in distilled water, the specific gravity is lower than that of cerebrospinal fluid. The high specific gravity liquid is used for sitting patients, and the liquid will sink to the cauda equina, which is safe and effective.

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