Back in 1962 I had an operation for a torn meniscus. The doc gave me a spinal, and after a few minutes, I felt that I couldn`t breathe and started panicking and then the docs put me out under general anesthesia. Now, I am scheduled to have a TURP, and the doc wants to give me a spinal again as the doc says she needs to be able to talk to me during the procedure. I am deathly afraid of getting the "not being able to breathe" problem again. I suppose the problem stems from the fact that I couldn`t move my lower adominal muscles during the procedure in 1962, which caused me to feel like I couldn`t breathe. Have things improved since 1962 as far as spinals go, or do I stand a chance of having the same problem again? If so, is there anything I can do to avoid the problem? 

Although it's 44 years ago this unpleasant experience is still vivid in your mind. In 1962 I was still in diapers. You were probably a young, active person and injured your knee playing hockey, skiing or on the football field. I would like to tell you that spinal anesthesia has changed radically since then. But it hasn't changed all that much. We still "stick" a needle (gently, of course) in your lower back and inject a small quantity of local anesthetic. Most of the local anesthetics we use today (lidocaine, bupivacaine) have been around for a good 30 to 40 years. 

What has changed is the size of the needle - much more delicate, narrow gauge needles are used today which minimize the risk of a postoperative headache. Monitoring has greatly improved, along with awareness of potential complications, allowing their prevention and/or early detection and treatment. 

What may be more important is that you have changed. You are older, probably wiser, and I would imagine a bit calmer in the face of adversity. As a more mature person you will probably be able to tolerate the unusual sensation of spinal blockade without panicking. If you are still extremely nervous, your anesthesia practitioner can offer you intravenous sedation along with the spinal. The sedative drugs available today have improved since 1962. They can provide you with a pleasant and tolerable experience. 

Finally, although spinal anesthesia is commonly used for TURP procedures it is not considered essential under normal circumstances. If you cannot face the prospect, please chat with your surgeon and your anesthesiologist ahead of time to make this clear to them and to allow consideration of the safe alternative - general anesthesia. 

I recently had a spinal tap because I had an emergency c-section. I was wandering if the pain I`m feeling around the injection site has anything to do with the spinal? 

A certain amount of discomfort around the injection site of a spinal anesthetic is quite common, but should improve quickly over a few days. The pain should be localized, with perhaps a bit of tenderness. If the anesthesiologist had to insert the needle in more than one site, or had more than one attempt to insert it, you may have more pain than usual. If the pain increases or is accompanied by redness, warmth, swelling, or a discharge you should immediately seek attention. These are signs of inflammation or infection. 

Back pain during pregnancy and after delivery is extremely common, occurring in at least 50% of cases. Sometimes the backache is attributed to the spinal anesthetic, but it is likely that in most cases there is no relation between the two. Such a backache would not be limited to the injection site of course.