epidural or spinal

         Whats the difference between epidural and spinal for surgery??  Confused-- I asked for an epiderual one time for knee reconstruction surgery ( ACL replaecament  & other ligament repairs )  When I went into OR the surgeon said he wanted my muscles totally deactivated and had me put totally to sleep .  The same doc did knee replacement on my sister and let them do an epidural.  Now a different Doc did a hip replacement on my father ( age 76 ) and wanted
a spinal instead of an epidural .   I do not understand why the differences?  The OR nurse said that the doc ( my fathers surgeon ) wants the muscles totally paralyzed and a spinal does that where a epidural deadens the nerves but can leave the muscles activated ( this may explain my reconstruction however not the same doc doing knee replacements with epidural ( patient request ) .
          In any case my father came through the surgery very well with very little blood loss and stabil BP throughout the surgery. The surgeon told me he did extremely well and they controlled his BP well with drugs by using very little
anestesia and he was awake for most of the procedure and only nodded off a few times.
         He explained quite a bit and didn't bother to ask about the spinal vs epideral--The nurse said they use epideral a lot for women and childbirth but orthepedic surgery.

         Dazed and confused- Can you elaborate.
I was also told spinals are more dangerous and give patients headaches??

[DrNavneetMD]

Hello Dear,
The difference between epidural and spinal anaesthesia is as follows;
In spinal anaesthesia,the desired effect is to block the transmission of nerve signals to and from the affected area. Sensory signals from the site are blocked, thereby eliminating pain, and motor signals to the area eliminate movement. In effect, the result is total numbness of the area and paralysis. This allows medical procedures to be performed with little or no sensation whatsoever to the person undergoing the procedure, and provides a still patient or area for the surgeon to work on.
Spinal anesthesia is placed in the low back (lumbar region). After a sterile prep and draping, local anesthetic is placed in the skin to numb the area where the Spinal needle will be placed. The Spinal needle passes between the vertebrae of the Spinal column through the dural membrane where the cerebroSpinal fluid is located. Once the placement of the needle is accomplished medicines including a local anesthetic and sometimes a narcotic are dispensed via the needle. The needle is then removed. The entire process usually takes anywhere from 5- 20 minutes.
Epidural anaesthesia is  a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation  and a loss of pain , by blocking the transmission of signals through nerves in or near the spinal cord. Epidural does not puncture the dura- anesthetic is intruduced outside the dura, so it bathes the nerves coming off the spinal cord.
Epidural anesthesia is most commonly placed in the low back (lumbar region). Unlike Spinal this technique may also be accomplished in the mid-back (thoracic region) for surgery in the area of the chest. After a sterile prep and draping, local anesthetic is placed in the skin numb the area where the Epidural need will be placed. The needle for Epidural passes between the vertebrae of the Spinal column to the Epidural space. Once the position is verified, a very small catheter(tube) is placed via the needle. The needle is then removed and the catheter remains in the Epidural space. The catheter is then taped to the patients back. Local anesthetics and narcotics given epidurally via this catheter. The procedure usually takes 10 - 25 minutes.
The risk of headache is. about 1% with Epidurals and 3% with Spinals.
Best