Actually doesn't really matter much whether you've had regional or general anaesthesia, that statement holds true pretty much. I have been saying it over and over but I don't think people really took it on board. It's not ONLY the surgery you have to recover from, that makes you feel lethargic and washout after practically nothing at all - it's the anaesthetic.
And - it's not particularly the drugs. It's the being rendered totally relaxed which is abnormal. We never really TOTALLY relax like that. And being still for 2-4 hours - that's abnormal too. It might be something to do with lactic acidosis (like athletes get when they've run a race) or something, I don't know. But I do know that the overall effects of the above combine to make you quickly and inexplicably tired and washed out.
So far as the pros and cons for spinal anaesthesia goes something like this:
Advantages
Cost. Anaesthetic drugs and gases are costly and the latter often difficult to transport. The costs associated with spinal anaesthesia are minimal.
Patient satisfaction. If a spinal anaesthetic and the ensuing surgery are performed skilfully, the majority of patients are very happy with the technique and appreciate the rapid recovery and absence of side effects.
Respiratory disease. Spinal anaesthesia produces few adverse effects on the respiratory system as long as unduly high blocks are avoided.
Patent airway. As control of the airway is not compromised, there is a reduced risk of airway obstruction or the aspiration of gastric contents. This advantage may be lost if too much sedation is given.
Diabetic patients. There is little risk of unrecognised hypoglycaemia in an awake patient. Diabetic patients can usually return to their normal food and insulin regime soon after surgery as they experience less sedation, nausea and vomiting.
Muscle relaxation. Spinal anaesthesia provides excellent muscle relaxation for lower abdominal and lower limb surgery.
Bleeding. Blood loss during operation is less than when the same operation is done under general anaesthesia. This is because of a fall in blood pressure and heart rate and improved venous drainage with a resultant decrease in oozing.
Visceral tone. The bowel is contracted during spinal anaesthesia and sphincters are relaxed although peristalsis continues. Normal gut function rapidly returns following surgery.
Coagulation. Post-operative deep vein thromboses and pulmonary emboli are less common following spinal anaesthesia.
Disadvantages ...
Sometimes it can be difficult to find the dural space and occasionally, it may be impossible to obtain CSF and the technique has to be abandoned. Rarely, despite an apparently faultless technique, anaesthesia is not obtained.
Hypotension may occur with higher blocks and the anaesthetist must know how to manage this situation with the necessary resuscitation drugs and equipment immediately to hand. As with general anaesthesia, continuous, close monitoring of the patient is mandatory.
Some patients are not psychologically suited to be awake, even if sedated, during an operation. They should be identified during the preoperative assessment. Likewise, some surgeons find it very stressful to operate on conscious patients.
Even if a long-acting local anaesthetic is used, a spinal is not suitable for surgery lasting longer than approximately 2 hours. Patients find lying on an operating table for long periods uncomfortable. If an operation unexpectedly lasts longer than this, it may be necessary to convert to a general anaesthetic or supplement the anaesthetic with intravenous ketamine or with a propofol infusion if that drug is available.
When an anaesthetist is learning a new technique, it will take longer to perform than when one is more practised. When one is familiar with the technique, spinal anaesthesia can be very swiftly performed.
There is a theoretical risk of introducing infection into the sub-arachnoid space and causing meningitis. This should never happen if equipment is sterilised properly and an aseptic technique is used. A postural headache may occur postoperatively. This should be rare