Tubal Reversal Anesthesia
Can Reversal Be Done With Spinal Anesthesia?

Can tubal reversal surgery be done with a spinal?

Although technically possible there are unique risk to spinal anesthesia which make this form of anesthesia unsuitable for outpatient tubal reversal surgery.

What is spinal anesthesia?

During spinal anesthesia, anesthesia is given by inserting a small needle into the spinal canal and the very start of the surgery.

Spinal anesthesia being administered at the start of the procedure.

A spinal is different than an epidural because the entire dose of medication is injected into the spinal canal all at once and at the start of surgery and a catheter does not remain in the spinal canal like with epidural anesthesia.

The main benefit of spinal anesthesia is anesthesia is quick, simple, and has less complications than epidural anesthesia.

It is also ideal for pregnancy because the baby does not become exposed to general anesthesia.

Can tubal reversal surgery be done with a spinal?

Spinal anesthesia is not ideal for outpatient tubal reversal surgery because patients are at increased risk of having an emergent drop in blood pressure and respiratory distress, risk of urinary retention, and risk of the spinal wearing off in the middle of surgery.

Spinal anesthesia and tubal reversal: Spinal anesthesia complications

Occasionally when anesthesia is placed into the spinal canal, the pain medication can go higher in the spinal canal than planned. This can cause an emergent drop in blood pressure or can temporarily stop patients from breathing. This is an emergent situation.

Although this is not common, this complication would require emergency intubation (insertion of a endotracheal breathing tube) and medications to reverse the drop in blood pressure.

Spinal anesthesia for tubal reversal: Urinary retention

Urinary retention is a major problem with spinal anesthesia. The  bladder may not work properly for the first 12 to 72 hours after spinal anesthesia. If this occurs then a patient will need a temporary bladder catheter until the bladder can begin to function. Bladder catheters increase the risk of bladder and kidney infections.

Spinal anesthesia and pain during tubal reversal surgery

When a spinal is used for tubal reversal anesthesia the pain medication is injected into the spinal canal at the very beginning of the procedure using a small needle. If the surgery takes longer than planned or if the dose of pain medication is too low then a patient is at risk of waking up or having full sensation while the surgery is going on. Once the surgery is underway it is not possible to re-dose the spinal and patients would then have to have general anesthesia.

Spinal for tubal reversal anesthesia: Not ideal

Can tubal reversal surgery be done with a spinal?

Technically tubal reversal can be done with a spinal but spinal anesthesia is not ideal for reversal surgery. If the surgery takes longer than expected patients will experience pain and will require general anesthesia. If the patient has urinary retention then they will require a temporary bladder catheter.

Spinal anesthesia is best for quick surgeries or surgeries where patents will be hospitalized overnight. Although spinal anesthesia is extremely safe, spinal anesthesia has unique complications which make this form of anesthesia less than ideal for outpatient tubal ligation reversal surgery.

For more information: Tubal reversal anesthesia: Best anesthesia for reversal surgery