Sacral anesthesia

The sacral anesthesia is an epidural anesthesia in the region of the sacrum for post-operative or post-traumatic pain management or for chronic pain, for example at disc herniation, herpes zoster (shingles) and chronic pain cause, particularly in the lumbar spine .

An epidural nerve block is performed. In this case, which is anesthetic injected into the spinal canal between the spinal cord, which then stuns the exiting nerve and thus elicits an analgesic effect.

Single injections with local anesthetics and steroids (e.g. cortisone to reduce inflammation) are used, sometimes with the addition of opioids (pain anesthesia).

execution

An injection needle is used to pierce the sacral hiatus (opening of the vertebral canal in the sacrum); After passing the hiatus (which shows up as a sudden loss of resistance when guiding the needle), the needle is advanced approx. 3–5 mm and then the anesthetic is applied.

The correct epidural position of the needle is checked with the help of the Weinberger symbol .

After aspiration (to rule out the intravascular location), the local anesthetic / corticoid is applied. The effect occurs after approx. 20 to 45 minutes, the duration of the blockade depends on the local anesthetic used.

Weinberger sign

The Weinberger symbol is a symbol for the epidural control of the position of the cannula when performing sacral anesthesia.

With the correct position between the dura mater (hard skin of the spinal cord) and the sacrum, a small, palpable bump under the skin occurs when the anesthetic is injected, which regresses when the injection pressure ceases, as the anesthetic then spreads upwards in the epidural space.

If the cannula is under the skin (subcutaneously), the fluid reservoir will not recede; the situation must then be corrected.

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