Difference Between Epidural and Spinal (With Table)

In medical science, anesthesia is a medication for reducing or eliminating the sensation or discomfort occurring during surgery or any significant operation. The patient’s body becomes numb as a result of anesthesia. Different types of anesthetics are given to the patient depending on the severity of the surgery. Epidural and spinal anesthesia are two distinct anesthesia. Both are for numbing different body parts depending on the patient’s condition.

Epidural vs Spinal

The main difference between epidural and spinal is that epidural anesthesia is local anesthesia. However, spinal anesthesia is regional anesthesia. Moreover, an epidural is injected into the epidural space (area between a dura mater and vertebral wall), and spinal anesthesia is injected into the dural sac (the tube around the spinal cord).

Epidural anesthesia is a type of local anesthesia that numbs a tiny part of the body. This anesthesia numbs the patient’s body in 15 minutes, although he stays attentive and awake. It is injected into the lower spine during labor and delivery to relieve pain. An anesthesiologist is a person who injects the medicine into the patient.

Spinal anesthesia is regional anesthesia that numbs a larger area of the body. This anesthesia numbs the body on the spot at least for two-three hours. The person might be awake or unconscious during the surgery. The needle used is fairly thin (3.5 in long). The anesthesia is injected into the membrane around the spinal cord.

Comparison Table Between Epidural and Spinal

Parameters of Comparison

Epidural

Spinal

Purpose

Epidural is given during the delivery of the women to prevent them from pain.

Spinal anesthesia is given if the surgery is related to genitals or any other lower part.

Injected into

Epidural is injected into the area present between the dura mater and vertebral wall.

Spinal anesthesia is injected into the dural sac.

Side Effects

Side effects of the epidural are low BP, fever, and loss of bladder control.

The side effect of the spinal is severe headache.

Pain Relief

It takes at least fifteen in numbing of the body after the epidural anesthesia injection.

It numbs the body immediately after the spinal anesthesia is injected into the body.

Dose of Medicine

Under epidural, a dose of anesthesia is higher.

Under spinal, a dose of anesthesia is lower due to the presence of the cerebrospinal fluid.

What is the Epidural?

Epidural is a Greek word that refers to the numbing of a smaller region of the body (the epidural space). In 1921, a Spanish military physician created this dose to numb the epidural area between the outer membrane of the spinal cord and the vertebrae.

After a decade of usage by Italian surgeons, this anesthetic dose became common. Furthermore, because this dose is administered during a normal delivery while the labor pain is present, the majority of American women gave birth after receiving this epidural at that time.

The patient does not experience any pain after receiving epidural injections within 10-15 minutes. The reason for this is that the dose blocks the signal that is sent from the nerve cell. This invention was a blessing for pregnant women because it spared them the agony of giving birth to a child.

This steroid is completely safe for pregnancy. This anesthetic should not be given to women with low platelets or significant bleeding. The dose is administered into the pregnant woman’s lower body, and she must be monitored continuously to avoid any effects on the central nervous system.

The side effects of this dose aren’t very terrible (loss of bladder control, lower blood pressure, fever). The size of the needle used is 3.5 inches.

What is Spinal?

August Bier (German surgeon) was credited for developing spinal anesthesia in the late 1800s. He is the first man to experiment with spinal anesthesia. Many names for spinal anesthetic exist, including spinal block, intradural block, and subarachnoid block. It is the type of regional anesthesia.

The anesthesiologists inject this dose into the dural sac (the deepest layer of the tissue around the spinal cord). This dose can be accompanied by an opioid or not into the cerebrospinal fluid (colorless fluid present in tissues around the brain).

Once the patient is injected, the dose immediately numbs the area of the patient for two to three hours. This anesthetic is injected into the patients to treat lower body parts (knee surgery, hip surgery, femur surgery).

Furthermore, this dose can be administered to a pregnant lady who is having a Cesarean delivery. While injecting this anesthesia, the patient is sometimes alert or unconscious during the surgery. The injection is not painful but gives a tingling effect when injected with a 9 cm needle.

However, one should be still while one is injected with anesthesia. The main side effect of anesthesia is a severe headache and difficulty urinating. The rare side effect is seizures and nerve damage.

Main Differences Between Epidural and Spinal

  1. Epidural was discovered by the Spanish surgeon Fidel Pagés. However, Spinal anesthesia was discovered by the German surgeon August Bier.
  2. The effect of the epidural anesthesia could remain up to four hours. On the other side, the numbness of spinal anesthesia remains for up to two hours.
  3. Epidural anesthesia is injected to keep pregnant women out of discomfort during labor. On the other hand, spinal anesthetics are injected to execute lower-body procedures.
  4. Epidural anesthesia numbs the body within 15 minutes. On the other side, spinal anesthesia numbs the body immediately after the injection.
  5. The dose of epidural anesthesia is stronger as compared to spinal anesthesia.

Conclusion

Epidural and spinal anesthesia are two types of anesthesia that are used in conjunction with other medications to numb the patient’s body parts during operations and surgeries. While giving these anesthesias to the patient, surgeons observe the patient for avoiding their effect on the central nervous system.

If not injected properly, it could paralyze some parts of the human body. Otherwise, these drugs are entirely safe to inject leaving some common side effects. Both anesthesias are based on a mechanism that blocks the transmission of signals from nerve fibers for a few hours, allowing patients to remain mostly awake while being treated.

References

  1. https://www.sciencedirect.com/science/article/pii/0304395988900851
  2. https://journals.lww.com/anesthesia-analgesia/Citation/1981/03000/Neurologic_Deficits_following_Epidural_or_Spinal.6.aspx