Spinal anaesthetic

Anaesthetics are medications that numb an area of your body and stop you from feeling pain during medical procedures. They can be local, regional or general.

• Local anaesthetics are used to numb a small area of the body. They can be injected or applied to the skin as a spray or cream
• Regional anaesthetics are injected into the nerves that supply a larger area of the body. You are still awake when you have a regional anaesthetic, but don't feel any pain
• General anaesthetics are administered through a vein and put you in a state of unconsciousness like a controlled deep sleep. You don't feel or remember anything when you have a general anaesthetic

A spinal anaesthetic is a type of regional anaesthetic

To discuss a private spinal anaesthetic with a consultant of your choice at Circle Health Group, call or book online today.

This page explains what a spinal anaesthetic is, how it works and what types of surgery it may be used for.

Spine injection for pain (1-2) (local anaesthetic)

Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.

Patient pathway	Initial consultation	Diagnostic Investigations	Main treatment	Post discharge care	Guide price
Hospital fees	N/A	Not included	£2,325	Included	£2,325
Consultants fees from	£200	N/A	Included	Included	£200
Guide price	£2,525

Spinal anaesthetics are injected into your lower back causing the lower half of your body to become numb. They can be used for surgery below the waist including:

• Orthopaedic (bone) surgery of the legs, feet, ankles, and hips
• Surgery involving the blood vessels of the legs
• Hernia surgery
• Haemorrhoid surgery
• Prostate, bladder, or genital surgery
• Surgery of the womb, vagina and ovaries
• Caesarean sections

A spinal anaesthetic is given by an anaesthetist in the hospital operating theatre. Other members of the operating theatre staff will be there to help the anaesthetist and support you during the procedure.

Before your spinal anaesthetic

Before the procedure, you will have a drip placed in your hand and the theatre staff will attach you to a monitor to keep an eye on your heart rate, blood pressure, and blood oxygen levels.

Your anaesthetist will explain everything to you, answer any questions you have and guide you through the procedure. We want you to feel as comfortable as possible before, during, and after having your spinal anaesthetic, so please ask any questions you may have at any time.

To administer your spinal anaesthetic, your anaesthetist needs to see the bones in your back clearly. To do this, they will help you to get into one of two positions:

• Sitting position: in this position you sit on the edge of the operating table with your back to the anaesthetist, your chin on your chest, and your shoulders rolled forward so that your back is curved
• Lateral decubitus position: in this position you lie on your side with your legs and shoulders curled inwards so that your back is curved

During the procedure

To minimise the risk of infection, the anaesthetist will clean your back with antiseptic, scrub their hands and wear a sterile gown, hat, gloves, and mask.

Next, they will feel along your spine with their fingers to find the correct place for the anaesthetic to be injected.

Once they have located the correct place, your anaesthetist will inject some local anaesthetic to numb the area. They are then ready to administer your spinal anaesthetic.

When the spinal needle is inserted, it's important that you stay very still. You should feel no pain during the procedure, but sometimes the needle can get too close to a nerve which causes a shooting pain down one of your legs. If you experience this, continue to stay still, and let your anaesthetist know which leg you feel pain in.

After having your spinal anaesthetic

After the anaesthetic has been injected, you may feel a warm, tingling sensation in your lower back and buttocks. This gradually spreads down your legs until they are completely numb. A spinal anaesthetic normally takes between five and fifteen minutes to work.

How do they know it's working?

Your anaesthetist will check the spinal anaesthetic is working in several ways. They may start by asking you to lift your legs off the bed. Your legs will probably feel heavy, and you may not be able to feel or lift them at all. If you cannot feel or move your legs, this is a good sign and means your spinal anaesthetic is working properly.

Your anaesthetist may use a cold spray to check that the spinal anaesthetic is working and the level at which it stops. When the anaesthetic is working properly, you will not be able to feel the cold spray.

It's very important that you are as relaxed and comfortable as possible throughout your procedure, so tell your anaesthetist if you have any questions or concerns at any time. 
Your operation will not start until your anaesthetist is satisfied that your spinal anaesthetic is working properly.

There are three different options to choose from when having a spinal anaesthetic. You will be able to discuss these options with your anaesthetist before your surgery and decide which approach is best for you. The three options for spinal anaesthesia are:

A spinal anaesthetic on its own

If you choose this option, you will be awake for your operation, but you will not feel, or be able to move anything from your waist down. You will be able to hear what is going on in the operating theatre and talk during your operation. If you prefer, you are welcome to bring headphones and listen to music during your surgery. A screen will be put up in front of you so that you won't be able to see your operation. You will not feel any pain during your procedure

A spinal anaesthetic with sedation

This combines a spinal anaesthetic with medication that makes you feel relaxed and drowsy. The sedation is only given once the anaesthetist is sure that your spinal anaesthetic is working properly. With this type of anaesthetic, you will be aware of your surroundings, but will feel quite sleepy. You will not experience any pain during the procedure

A spinal anaesthetic in combination with a general anaesthetic

Sometimes a spinal anaesthetic is combined with a general anaesthetic that puts you to sleep for your operation. This may happen because your spinal anaesthetic can't be administered or isn't working effectively. Your anaesthetist may also decide to use a general anaesthetic if the operation goes on for longer than expected

After your operation, your spinal anaesthetic will gradually start to wear off and you may feel a tingling sensation in your lower body as sensation and movement return. Spinal anaesthetics normally wear off after about two to three hours depending on which drugs are used.

Some advantages of having a spinal anaesthetic over a general anaesthetic include:

• Lower risk of getting a chest infection after surgery
• Lower risk of lung or breathing problems
• You are less likely to feel sick or be sick after your operation
• No 'hangover', which is common after a general anaesthetic
• Excellent pain relief after surgery which reduces the need for strong painkilling medications
• You can eat and drink sooner after your surgery
• Less risk of confusion, especially in the elderly

Like all anaesthetics, there are some risks and possible side effects you need to be aware of before having a spinal anaesthetic.

Your anaesthetist will discuss these with you before your surgery and answer any questions you may have so that you can make an informed decision.

Common side effects of spinal anaesthetic include:

• Itching - this can be a side effect of the anaesthetic medication
• Low blood pressure - your anaesthetist will monitor your blood pressure carefully throughout your operation and start treatment such as intravenous fluids or medication if it becomes too low
• Difficulty passing urine —this is more common in men. If this happens during your procedure, a urinary catheter may be inserted into your bladder to drain urine until your spinal anaesthetic has worn off completely

Uncommon side effects of spinal anaesthetic include:

• Spinal headache - A spinal headache may occur up to 5 days after having a spinal anaesthetic, though it usually happens within the first two days. Most spinal headaches go away without treatment and are managed by lying down, drinking lots of fluids, and taking painkillers. If your headache lasts longer than a few days, or if you develop a severe headache after having a spinal anaesthetic, seek immediate medical attention

Rare side effects of spinal anaesthetic include:

• A high block - very rarely, a spinal anaesthetic can affect areas of your body above your waist. This may cause weakness in your arms, or rarely, problems with your breathing. If this happens, your anaesthetist will assist you with breathing until the spinal anaesthetic has worn off
• Postoperative sensorineural hearing loss (SNHL) - this rare condition affects your ability to hear low-frequency sounds. SNHL normally resolves on its own within a few days, but in very rare cases may be permanent
• Nerve damage - permanent nerve damage is extremely rare, affecting about 1 in every 50,000 people who have a spinal anaesthetic. Temporary nerve damage is slightly more common and may cause temporary numbness, muscle weakness, and pins and needles. These symptoms resolve on their own within a few days or weeks

After your operation is over, your spinal anaesthetic will start to wear off. You may feel tingling or pins and needles in your legs as the effects of your anaesthetic subside. The time it takes for your anaesthetic to wear off depends on the exact medications used, but it has normally worn off completely after about four hours, and you will be able to get out of bed after six hours. Ask for help from a healthcare professional when you get out of bed for the first time after your procedure to make sure you are not weak or unsteady.

Your consultant will prescribe painkillers for you to take as your spinal anaesthetic wears off. If you feel pain after your surgery, ask for painkillers as soon as possible. It's important that you are as comfortable and pain-free as possible after your operation. Don't wait for your pain to become severe. This can make it harder to treat and may stop you from moving around, which can lead to complications.

We answer some commonly asked questions about spinal anaesthetics.

Is a spinal anaesthetic the same as an epidural?

No. Both spinal anaesthetics and epidurals are types of regional anaesthesia that numb the body below the waist, but there are some differences between them.

During an epidural, a thin plastic tube is inserted into the epidural space (the potential space between the spinal cord and the backbone). This is attached to an infusion pump so that the anaesthetic can be topped up as needed. Epidurals are commonly used during childbirth.

Spinal anaesthetics are given as a single injection into the cerebrospinal fluid (the fluid that surrounds the brain and spinal cord).

Can a spinal anaesthetic cause hearing loss?

Rarely, spinal anaesthetics can cause a condition called postoperative sensorineural hearing loss (SNHL). This can affect one or both ears and affects your ability to hear low-frequency sounds. Most cases of SNHL resolve by themselves within a few days, but in rare cases, the condition is permanent and may be accompanied by tinnitus (ringing in the ears) and vertigo ( a feeling that you or your environment are moving or spinning). If you experience hearing loss after having a spinal anaesthetic, seek immediate medical attention.

Can I have an ankle replacement under a spinal anaesthetic?

Yes. A spinal anaesthetic is often used for orthopaedic (bone) surgery involving the lower part of the body such as the hips, legs, feet, and ankles.

What if I don't want to be awake during my operation?

If you don't want to be awake during your operation, you can opt for a different type of anaesthetic such as a spinal anaesthetic with sedation, or a general anaesthetic. It's very important to us that you are comfortable and well-informed about every aspect of your surgery. Before your operation, discuss your preferences and the different anaesthetic options with your anaesthetist, who will help you decide on the best option for you.

How soon after a spinal anaesthetic can you have a shower?

After your surgery, you may need to wait around 48 hours before taking a shower. This is more to do with the surgery itself than the spinal anaesthetic as you may have dressings in place that need to stay dry. Talk to your consultant about when you can expect to take a shower after your surgery.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant best suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about spinal anaesthetics, book your appointment today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in November 2022. Next review due November 2025.

Spinal Anesthesia PubMed 
Spinal Anaesthetic NHS 
Anaesthesia NHS
Spinal Anaesthetic  Patient info
 Anaesthesia explained Royal College of Anaesthetists