Our Summary

This research paper reviews existing literature to answer three important questions related to regional anesthesia (a type of anesthesia that numbs a specific area of the body).

First, it explores how doctors can test the effectiveness of the anesthesia before surgery, and how quickly they can determine its success or failure after it’s been administered. The paper suggests using a variety of sensory tests before the operation begins; changes in temperature and thermal images might give an early indication of whether the anesthesia is working or not.

Second, the study looks into whether doctors can predict if anesthesia administered after a patient has been put to sleep will be effective when they wake up. There are several ways to measure pain sensation during general anesthesia, but none of these methods have been used to evaluate the effectiveness of regional anesthesia.

Finally, the paper discusses what signs doctors should look for, and how long they should wait, before becoming concerned if the anesthesia does not wear off as expected after surgery. It provides guidelines for when further examination and a referral to a neurologist might be necessary if symptoms of the anesthesia persist.

FAQs

  1. What methods are available for testing the degree of regional blockade pre-operatively and how can the success or failure be determined post-injection?
  2. How can we predict if a block inserted after the induction of general anaesthesia will be effective when the patient wakes up?
  3. What signs and duration should raise concern when a block does not resolve as expected after surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal surgery is to follow all post-operative care instructions carefully, including proper wound care, medication management, and physical therapy exercises. It is important to attend follow-up appointments and communicate any concerning symptoms or changes in pain levels to your healthcare provider promptly. Additionally, maintaining a healthy lifestyle through regular exercise and proper nutrition can aid in the recovery process.

Suitable For

Spinal surgery is typically recommended for patients who have not responded to conservative treatments such as medication, physical therapy, or injections. Patients who may be recommended for spinal surgery include those with:

  1. Herniated discs: If conservative treatments have not provided relief for a herniated disc that is causing severe pain, weakness, or numbness, surgery may be recommended to remove the protruding disc material.

  2. Spinal stenosis: Surgery may be recommended for patients with spinal stenosis, a condition where the spinal canal narrows and puts pressure on the spinal cord or nerve roots, causing pain, weakness, or numbness.

  3. Scoliosis: Surgery may be recommended for patients with severe scoliosis, a condition where the spine curves sideways, causing pain, difficulty breathing, or other symptoms.

  4. Spinal fractures: Surgery may be recommended for patients with spinal fractures, especially if the fracture is unstable or causing neurological symptoms.

  5. Spinal tumors: Surgery may be recommended for patients with spinal tumors that are causing pain, neurological symptoms, or spinal instability.

It is important for patients to discuss their symptoms, treatment options, and potential risks and benefits with their healthcare provider to determine if spinal surgery is the best course of action for their specific condition.

Timeline

Before spinal surgery, a patient may experience symptoms such as back pain, numbness or weakness in the limbs, and difficulty walking or standing. They may undergo diagnostic tests such as X-rays, MRIs, and nerve conduction studies to determine the source of their symptoms and the need for surgery.

After spinal surgery, the patient may experience pain and discomfort at the surgical site, as well as numbness, tingling, or weakness in the limbs. They will be closely monitored in the hospital for any signs of infection, blood clots, or complications from the surgery. Physical therapy and rehabilitation may be recommended to help the patient regain strength and mobility in the affected area. Follow-up appointments with the surgeon will be scheduled to monitor the patient’s recovery and address any concerns or complications that may arise.

What to Ask Your Doctor

  1. What type of spinal surgery is being recommended and why is it necessary?
  2. What are the potential risks and complications associated with the spinal surgery?
  3. How long is the recovery period expected to be and what can be done to help speed up the recovery process?
  4. What type of anesthesia will be used during the surgery and what are the potential side effects or risks associated with it?
  5. What can be done to manage pain and discomfort after the surgery?
  6. What are the potential long-term effects or complications that may arise from the spinal surgery?
  7. How successful is this type of surgery in treating the specific condition or issue I am experiencing?
  8. What are the alternative treatment options available and how do they compare to spinal surgery in terms of effectiveness and risks?
  9. What can I do to prepare for the surgery and optimize the outcome?
  10. How often will follow-up appointments be needed after the surgery and what will be monitored during those appointments?

Reference

Authors: Ode K, Selvaraj S, Smith AF. Journal: Anaesthesia. 2017 Jan;72 Suppl 1:70-75. doi: 10.1111/anae.13742. PMID: 28044336