Some complications, side effects of spinal anesthesia in surgery

The article is professionally consulted by Specialist Doctor I Tran Thi Anh Hien - Department of Surgical Anesthesia - Vinmec Central Park International Hospital and Specialist I Nguyen Duc Thong - Anesthesiologist Resuscitation - Department of General Surgery - Vinmec Da Nang International General Hospital.

In recent years, spinal anesthesia is one of the widely used methods in medicine. However, performing this method also causes some complications and side effects during and after surgery.

Spinal anesthesia is also known as subarachnoid anesthesia. This is a form of regional anesthesia. The doctor will inject anesthetic into the space between the soft membranes of the spine and the arachnoid membranes. Nerve transmission from the spinal cord will be numbed by the effect of the anesthetic to relieve pain in certain areas of the body.

In addition to some advantages of spinal anesthesia, such as: The amount of blood during surgery is reduced, the rate of venous thrombosis is reduced, and respiratory failure is prevented in emergency cases.
The method of spinal anesthesia has a fairly high safety rate if the drug is used in the right dose. However, spinal anesthesia also causes a number of complications and undesirable side effects, most of these complications are related to the anesthetic or related to the technique such as:
Central nervous system complications : The rate of neurological complications after surgery using spinal anesthesia will increase if the patient has some other disease or spine disease. + Neurological symptoms: Some other symptoms are observed after spinal anesthesia such as pain, burning in the buttocks, indigestion... Usually these symptoms will subside in 2 days. For local anesthetics, the risk of these symptoms is lower.
Cardiovascular complications: Some cardiovascular complications occur after spinal anesthesia such as + Hypotension: This is an unavoidable complication when performing spinal anesthesia. If the blood pressure drops for a long time, it will not recover, causing danger to the patient.
+ Arrhythmia and cardiac arrest: often cause bradycardia, These are extremely dangerous complications that can cause cardiac arrest if bradycardia is not detected and treated promptly.

Complications of total spinal anesthesia: This is a rare but extremely dangerous complication caused by injection in the wrong place. General anesthesia of the spinal cord will cause the patient's blood pressure to drop suddenly, the paralysis will progress quickly, there may be temporary cessation of breathing, loss of consciousness, dilated pupils, and because of the nerve block, there may be respiratory failure occurs. Upper airway obstruction: With typical symptoms such as nasal congestion and shortness of breath, decreased breathing, stopped breathing. Headache: This is the most common neurological complication following spinal anesthesia. This complication often occurs in middle-aged women and pregnant women after giving birth. A headache after spinal anesthesia usually occurs around the forehead, behind the eyes, or at the base of the skull (anterior occipital region), and begins when the patient stands up. The pain can range from mild to severe and can be sharp or dull. Headache may be accompanied by some other symptoms such as nausea, vomiting, lasting from 1 to 4 days after surgery. Cerebrospinal fluid leaks through the dural perforation, reduces the buffering barrier of the sensory nerves, and decreases the cerebrospinal pressure, which is the main cause of headache after spinal anesthesia. Besides headaches, leaking cerebrospinal fluid can also put patients at risk for hearing loss. Urinary retention: This complication can occur due to spinal anesthesia in the postoperative period, making the patient feel uncomfortable, more serious can cause neurogenic bladder syndrome

Hematological complications: One of the serious complications after spinal anesthesia is spinal hematoma. This complication requires early surgery to avoid permanent nervous system damage. Infection: Meningitis is a rare complication after spinal anesthesia but causes serious harm to patients, which can cause permanent neurological damage, even death. Some other causes of infection such as anaerobes, anaerobic gram-negative bacilli, bacteria... Therefore, when performing spinal anesthesia, doctors and technicians need to strictly follow them strictly. principles of asepsis, especially for patients with compromised immune systems. Local anesthetic poisoning: There is toxicity on the central nervous system and heart due to high drug concentration in the blood with accompanying symptoms such as dizziness, tinnitus, metallic taste in the mouth, shock, coma, convulsions , arrhythmia ... This is the most dangerous complication of spinal anesthesia. Pain in the needle puncture site: Patients may experience damage to the subcutaneous tissue or ligaments caused by the procedure. Other side effects: itching, vomiting, nausea. Due to a number of advantages such as reasonable cost, alertness during surgery, early recovery after surgery, and avoidance of complications caused by anesthesia with intubation, etc., currently spinal anesthesia methods are very popular. patient choice when performing surgery. However, before choosing to have this procedure, you should consult with your doctor to anticipate the possible risks after surgery.

Spinal anesthesia is not used in some cases due to some of the following factors:
Cardiovascular disease such as heart failure, mitral stenosis, severe aortic valve regurgitation, myocardial ischemia Blood Unstable pressure Spine pain Headache Allergic to anesthetics Abnormal deformity of the spine Patient is taking anticoagulants Coagulation disorders Infected puncture site Patient is malnourished Graduated from the program Trained as a Resident Doctor, Doctor Tran Thi Anh Hien has experienced many different working environments such as Binh Dan Hospital, Ho Chi Minh City University of Medicine and Pharmacy Hospital, and Phap Viet Hospital before returning to work. at the Anesthesia and Anesthesia Unit - Department of Surgical Anesthesia - Vinmec Central Park International General Hospital.
Doctor Duc Thong has 14 years of experience in the field of Anesthesia. Especially, with 12 years working at the Department of Anesthesiology and Resuscitation at C Da Nang Hospital, Dr. Thong has extensive experience in the field of Anesthesia and resuscitation for elderly patients with many comorbidities and serious illnesses. surgery; helping many heavy and complicated surgeries to be successful. Currently, he is an anesthesiologist at the Department of General Surgery - Vinmec Da Nang International General Hospital.
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