Orthopaedics

Spinal anaesthesia is suitable for:

• Operations to the foot, knee, and hip
• Lower limb amputations

Urology

Spinal anaesthesia is suitable for:

• TURP
• Cystoscopy
• Testicular surgery
• Scrotal surgery
• Some major urological surgery is too prolonged or has potential for large blood loss making it unsuitable for spinal anaesthesia.

Gynaecology

Spinal anaesthesia is suitable for:

• Hysterectomy
• Vulval surgery
• Fistula surgery (if less than 2 hours)
• Some surgery lasts too long for spinal anaesthesia. Laparoscopy is poorly covered by spinal anaesthesia

General surgery

Spinal anaesthesia is suitable for:

• Anal surgery
• Inguinal hernia
• Abscesses below the level of the umbilicus
• Appendicectomy (unless the patient has a ruptured appendix and generalised peritonitis)

Time limitations

Regarding time limitations, consider:

• The length of time that a spinal lasts will depend on the local anaesthetic used, the volume of local used, and any adjuncts added
• Lidocaine is the fastest but shortest acting
• Bupivacaine and ropivacaine are longer acting