Long-term effects of spinal anesthesia

What is meant by long-term effects

Long-term effects describe side effects that persist beyond the immediate period of the intervention. Since many side effects can occur with spinal anesthesia, which subside within a few days, these are not to be counted as late effects. Only when symptoms persist after weeks or months are these long-term consequences. These are significantly less common than normal side effects, but they offer great limitations and pain for those affected.

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What are the long-term effects?

The long-term effects of spinal anesthesia amplify the direct side effects and remain for a longer period of time.

The usual side effects, which can persist over a longer period of time, are headache and nausea. In addition, the dizziness can last longer. With the headaches that often result from the loss of brain water, neck stiffness can occur. Some people also suffer from incontinence or urinary retention, as the nerves that control the bladder can become irritated.

The puncture can cause a bruise or swelling to form, which puts pressure on these and other nerves. Those affected have symptoms similar to those of a herniated disc with radiating pain in the legs. In rare cases, an infection involving the meninges can develop through the injection site. Such meningitis can have serious consequences. It is also possible to develop an allergy to the anesthetics, which can cause difficulties in the event of renewed spinal anesthesia.

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CSF loss syndrome

Our brain and spinal cord swim in a fluid called liquor, or cerebrospinal fluid. This fluid is located between the membranes of the spinal cord and meninges. In spinal anesthesia, the outer meninges are pierced and the anesthetic is injected into the spinal canal. A little brain water always escapes here. Since the amount of cerebrospinal fluid is very precisely adjusted, even the loss of this small amount leads to headaches.

Normally, the hole in this skin closes automatically after the needle is removed. In some people, however, an opening remains and cerebral fluid continues to leak out. In this case, the headache also persists. People with certain pre-existing conditions, such as Marfan syndrome, are particularly affected. Other symptoms include dizziness and a stiff neck. Spinal anesthesia is not the only reason for CSF loss syndrome.

A so-called blood patch is a suitable treatment for many sufferers. Here, the body's own blood is injected into the place of the opening and the opening is closed. In some cases, surgery is also necessary.

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Nerve root irritation

Between the individual vertebral bodies, the spinal cord releases the individual nerves for different body regions. The first piece of this nerve is called the nerve root. With spinal anesthesia, nerves are only very rarely injured directly, but subsequent irritation through a bruise can occur. There is only a very limited space in the spinal canal in which a bruise can spread, which can quickly result in pressure on the nerves. The symptoms are the same as with a herniated disc. Those affected suffer from severe back pain that extends into the legs. If the cause is a bruise, the nerves usually recover once the pressure is removed.

Symptoms only persist in rare cases. This happens especially when the pressure has been sustained for too long and the nerves are permanently damaged. Another cause of nerve root irritation in the context of spinal anesthesia can be an abscess at the injection site. Symptoms are the same, but treatment is more important as it can be bacterial inflammation and meninges must be avoided.

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