Epidural and spinal anaesthesia

Aspect

Epidural Anesthesia (EA)

Spinal Anesthesia (SA)

Needle

Touhy needle

Spinal needle

(Quincke, whitacre,

Sprotte tip)

Injection of

anesthetic

into epidural space

(b/w ligamentum flavum
& duramater)

into subarachnoid space

(directly into CSF)

Spinal level

that can be

performed

Anywhere along the
verteral column

Lumbar only (mostly below

the L2 vertebra; where

spinal cord ends)

Location

Epidural space,

outside the dura mater.

Subarachnoid space,

inside the dura mater.

Drug dose

Larger dose than SA

Smaller dose than EA

Onset of

Action

Slower (10-20 minutes).

Rapid (2-5 minutes).

Duration of

block

Adjustable, prolonged

Brief, usually 2-4 hours

Redosing

Possible via inserted catheter

Not possible

Hypotension

& Headache

No; because there is
no CSF leak

Yes; due to CSF leak

Duration of

Effect

Can be prolonged by continuous
infusion or repeated dosing.

Typically shorter, single dose.

Control of

Dosage

Adjustable, can be topped up or

adjusted as needed.

Fixed dose, limited to the
initial injection.

Level of

Sensation

Blocked

Can be adjusted to block
specific segments.

Generally results in a more
uniform block.

Common

Uses

Labor and delivery

Surgeries of lower body

Postoperative pain management

Cesarean sections