Difference Between Spinal Anesthesia and Epidural Anesthesia

There are three layers of meninges in the spinal cavity: the dura mater, the arachnoid, and the pia mater. The space between the vertebral body periosteum and the dura mater is the epidural space. Between the arachnoid and the pia mater covering the spinal cord is the subarachnoid space.

Spinal anesthesia, also called subarachnoid block anesthesia, is administered in the subarachnoid space. There is cerebrospinal fluid and spinal cord in this cavity, so the dosage is relatively small, and the block is below the anesthesia level, which is commonly referred to as lower body anesthesia, and the sensation and movement below the anesthesia level are blocked.

Epidural block anesthesia is administered in the epidural space, which contains loose connective tissue, blood vessels and lymphatic vessels. By administering the drug in the epidural space, the spinal nerve root can be blocked, and the block range is segmental. Sexually, that is, block the sensory and motor nerves in the plane innervated by one or several spinal cord segments according to the interval of administration. Postoperative patient-controlled analgesia (PCA) is usually performed with epidural catheters.

In adults, the spinal cord is usually scattered below the lumbar 1 segment into a cauda equina suspended in the cerebrospinal fluid, and the spinal cord is not easily damaged by puncture. Therefore, spinal anesthesia is usually suitable for the part below the lumbar 1, and the operation suitable for spinal anesthesia is also applicable to the dura mater. In addition, because the epidural does not communicate with the intracranial, it is theoretically suitable for any operation except craniocerebral surgery, but in practice it is generally below the thoracic segment. The risk of problems is also greater. Spinal anesthesia and epidural anesthesia can be performed at the same time, called combined spinal-epidural block anesthesia, to provide more sustained and extensive surgical analgesia and anesthesia.

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