spinaalepiduraalne

Spinaalepiduraalne is a combined spinal-epidural anesthesia technique used for surgical procedures, particularly in obstetrics and lower limb surgery. It involves administering both a spinal anesthetic and an epidural anesthetic into the epidural space, which is the area surrounding the dura mater, the membrane that encloses the spinal cord.

The spinal anesthetic is delivered directly into the cerebrospinal fluid within the subarachnoid space, providing rapid onset and dense blockade of sensory and motor nerves. The epidural anesthetic is then administered into the epidural space, which is outside the dura mater. This provides a slower onset but allows for titration and prolonged anesthesia through an epidural catheter.

This combined technique offers several advantages. It allows for a faster onset of anesthesia than a pure epidural, while the epidural component provides the flexibility to extend the duration of anesthesia or manage postoperative pain. It can achieve profound sensory block with less motor block compared to a pure spinal anesthetic of similar duration.

The procedure is performed by an anesthesiologist. A needle is inserted into the epidural space, and through this needle, a smaller needle is advanced into the subarachnoid space for the spinal injection. The epidural needle is then used to thread a catheter into the epidural space. Once the spinal anesthetic takes effect, the epidural catheter can be used to administer additional anesthetic if needed. Potential complications are similar to those of spinal and epidural anesthesia individually and may include headache, hypotension, and nerve injury, although these are rare.