For local anesthesia, the patient is first relaxed with intravenous agents. Then a mixture of quick and long-acting anesthetic agents are injected into and under the skin in the area to be operated on or in a pattern that blocks the nerves to the area. The patient feels an initial sensation like a bee sting. As the anesthesia begins to take effect, the patient should feel no pain. This approach avoids potential complication of regional and general anesthesias and leaves the patient awake and cooperative to strain and demonstrate the solidity of the repair.
Spinal anesthesia is done by injecting an anesthetic agent into or around the spinal canal to block pain sensation from the lower half of the body. The patient remains awake during the procedure but may be sedated. The recovery time is longer than with a local anesthesia and the patient may experience difficulty urinating in the post op period. A headache may result from leakage of cerebrospinal fluid through the puncture site. Spinal anesthesia would not be used if there are preexisting back problems.
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