What's the difference between a spinal and epidural and a combined spinal-epidural?

The spinal cord and the nerves are contained in a sac of cerebrospinal fluid. The space around this sac is the epidural space (see section on 'Regional anesthesia'). Spinal anesthesia involves the injection of numbing medicine directly into the fluid sac.

Epidurals involve the injection into the space outside the sac (epidural space). Spinals and epidurals have the same effect (i.e. Numbs a large region of the body) because they both involve numbing of the nerves as they branch off the spinal cord.

Since the spinal injection is more "direct", the effect is immediate. Spinals are usually the first choice of anesthetic for women who are not in labor but need a Cesarean delivery. Epidural anesthesia takes a little longer to establish desired affect.

Because a small tube (catheter) can easily be placed in the epidural space, repeated doses of medicine can be given to maintain anesthesia as long as needed. Epidurals are the primary way of relieving pain in women that request analgesia for ... more.

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