Why Anesthesia Matters for Your Lumbar Spine Surgery
- Jen Overton
- Jun 2, 2025
- 8 min read
Updated: Nov 21, 2025
Lumbar spine (or lower back) surgery addresses conditions affecting the lower back, such as herniated discs, spinal stenosis, or degenerative disc disease. A laminectomy removes part of the vertebra to relieve pressure on nerves, a discectomy removes a damaged disc, and a spinal fusion stabilizes the spine using hardware or bone grafts.
These procedures are performed through an incision in the lower back and require general anesthesia to keep you fully asleep, relaxed, and pain-free during the surgery, which typically lasts 1–4 hours depending on the procedure’s complexity. Local anesthetic infiltration is often used to manage postoperative pain, reducing discomfort during recovery.
While there’s a risk of blood loss, particularly with spinal fusion, we use advanced monitoring and safety measures to keep you safe throughout the procedure. This combination supports a comfortable surgery and a smoother recovery during your hospital stay.
Your Day-of-Surgery Anesthesia Experience
Before Surgery: Meeting Your Anesthesia Team
On the morning of your surgery, you’ll arrive at the hospital and check into the preoperative area. Lumbar spine surgery is often an inpatient procedure, requiring a hospital stay of 1–5 days, depending on the type of surgery and the number of levels (e.g., discectomy may be shorter, fusion longer), your overall health, and recovery progress (e.g., pain control and mobility). Your surgical team should discuss your care plan based on these factors and the specific procedure prior to arrival at the hospital.
In the preoperative area, you’ll meet your anesthesia provider—a nurse anesthetist like me or an anesthesiologist. We’ll review your medical history, medications, allergies, and any concerns about pain or recovery to tailor your anesthesia plan. This is your chance to ask us all the questions about anesthesia or pain management. If you’re feeling nervous, let us know—we can likely offer reassurance or even a mild sedative to help you relax before heading to the operating room.
Addressing the Risk of Blood Loss
Some blood loss is a potential risk during lumbar spine surgery, particularly with spinal fusion, which involves more extensive tissue manipulation and hardware placement compared to laminectomy or discectomy. The amount of blood loss varies but is generally manageable, and significant complications are rare. To ensure your absolute safety, we take several precautions:
Preoperative Assessment: We check your blood counts and health status to optimize you for surgery, addressing any conditions like anemia.
Intraoperative Monitoring: We use advanced monitors to track your vital signs, oxygen levels, and blood loss in real-time. Devices like pulse oximeters and arterial lines (if needed) help us respond immediately to any changes.
Blood Management: Our eyes are on you and your vital signs. We are watching so closely and have IV fluids, medications, and even blood transfusions ready to replace any significant blood loss, though transfusions are rarely needed for most patients.
Team Coordination: Your anesthesia and surgical teams work together to keep your procedure safe, with constant communication to address any concerns.
General Anesthesia: What to Expect
Lumbar spine surgery requires general anesthesia to keep you fully asleep, relaxed, and pain-free, ensuring muscle relaxation and immobility during the delicate work on your spine.
Purpose of General Anesthesia
General anesthesia ensures you’re completely unaware and comfortable, allowing the surgeon to safely perform your laminectomy, discectomy, or fusion. It also enables us to control your breathing with a breathing tube, keeping your airway safe and vital signs stable during this procedure.
The Process
Getting Started: Once we roll you into the operating room on your stretcher, we’ll place monitors to track your heart rate, blood pressure, and oxygen levels using noninvasive devices (like sticky patches or a finger clip).
IV Medication: You should have an IV in place from the pre-operative area and we use this to deliver anesthesia medications.
Falling Asleep: We’ll give you oxygen through a gentle mask that fits over your nose and mouth, then administer anesthesia medication through your IV. Within seconds, you’ll drift off to sleep, like taking a nap.
After you’re asleep: We will place a breathing tube to keep your airway safe and help you breathe during surgery. You won’t feel or remember this step at all. Once the breathing tube is secured, the surgical team will carefully reposition you to a prone (tummy-down) position, on a specialized table to access your lower back, but of course, you won’t be aware of this.
During Surgery: We monitor you closely throughout your procedure, adjusting medications and fluids to maintain stability and manage any blood loss.
Waking Up: After surgery, we stop the anesthesia gas and medications, and you’ll wake up in the recovery room. The breathing tube is removed before you’re fully awake, so you won’t even remember it.
Want to learn more about general anesthesia? Click on the image below to read, General Anesthesia: The Patient Experience from Start to Finish
Local Anesthesia (by surgeon)
Purpose
Local anesthetic infiltration involves injecting numbing medication (e.g., bupivacaine) into the tissues around the surgical site, often at the end of surgery. Local anesthesia for these procedures can provide pain relief for 6–12 hours and eases early recovery.
The Process
This is performed by the surgeon, usually at the end of surgery, but always while you’re under general anesthesia:
Injection: The surgeon injects local anesthetic into the muscles and tissues around the incision site, targeting pain-sensitive areas.
What You’ll Feel: Since this is done while you’re asleep, you won’t feel the injection at all! When you wake up, the surgical area will feel numb, reducing any initial pain, though you may feel some discomfort as it wears off. Rest assured, your recovery team will be administering pain medication as the area near your incision wakes up.
Why Is General Anesthesia the Only Real Anesthesia Option?
There are several reasons that general anesthesia is mandatory for this type of surgery.
· Safety: General anesthesia is required for lumbar spine surgery to ensure your safety and comfort and to ensure that you stay immobile in a prone position.
· Muscle relaxation: Muscle relaxation or muscle paralysis (temporary) is required for this type of surgery not only due to your position, but also because those muscles that attach to your spine can affect its alignment. To have the precise results needed, muscle relaxing medicines are a must.
Share any preferences or concerns (e.g., about pain, blood loss, or recovery) with your anesthesia team and any mobility issues. We’ll work with you and your surgeon to create a plan that feels right.
Want to know How Many Times Is It Safe to Have Anesthesia? Click the image below to learn more.
Recovery: Inpatient Stay
After surgery, you’ll spend 1–2 hours in the recovery room, where nurses monitor you as you wake up fully. You may have a urinary catheter temporarily. This will be removed as you recover, and physical therapy may begin to help with mobility.
When you wake up in recovery, you may feel groggy, chilly, or have a dry mouth or sore throat from the breathing tube. The local infiltration (if used) will help to reduce pain at the surgical site, though you may still feel some lower back discomfort or stiffness. We’ll provide pain relief with oral or IV medications and comfort measures as you need them.
Lumbar spine surgery typically requires a hospital stay of 1–5 days, depending on the procedure:
Discectomy or Laminectomy: Often 1–2 days for less invasive procedures, as pain and mobility improve quickly.
Spinal Fusion: Sometimes 3–5 days due to the more extensive surgery, need for pain control, and monitoring for complications like blood loss or infection.
Rest assured that if you’re staying in the hospital, there is good reason. During your stay, you’ll receive pain medications, support for care and mobility (e.g., walking with assistance), and guidance on safe movements to protect your spine while you heal. We’ll monitor for signs of complications from any blood loss and ensure your safety with regular checks. Before discharge, we’ll provide instructions for pain management, activity restrictions (e.g., avoiding bending or heavy lifting), medication, physical therapy, and follow-up care to support your recovery.
And Speaking of Pain Medication…
Let me touch on Patient-Controlled Analgesia (PCA). Sometimes following a big procedure like spinal fusion, a PCA pump may be used to deliver IV pain medication on demand. These systems are like fancy IV drips that can be controlled by the patient (maybe you).
An IV bag holds opioid narcotic pain medication and is attached to an IV pump that delivers the medicine when the patient presses a button. It’s like having your own bell to ring! Rest assured that these systems have safeguards to prevent overdose.
Tips to Prepare and Reduce Anxiety
Feeling prepared can ease your nerves and set you up for a smooth surgery. Here are some tips:
Ask Questions: Write down concerns about anesthesia, blood loss, pain, or recovery and ask them during your preoperative visit or on the day of surgery. No question is too small.
Understand Your Procedure: Knowing whether you’re having a laminectomy, discectomy, or fusion can help you feel more in control. Ask your surgeon for details.
Practice Relaxation: If you’re anxious, try slow, deep breathing or visualization techniques. We can guide you through relaxation strategies if needed.
Plan for Recovery: Arrange for support during your hospital stay and at home after discharge. Have a comfortable recovery space ready, as recommended by your surgeon.
Trust Your Team: Your anesthesia and surgical teams are dedicated to your safety and comfort. We’ll monitor you closely, manage any blood loss, and adjust care to meet your needs.
Still worried about having anesthesia for your back surgery? Click the image below to read How to Overcome the Fear of Anesthesia: TIps for a Better Surgery Experience.
Final Thoughts
Anesthesia for your lumbar spine surgery is designed to keep you pain-free and relaxed, allowing your surgeon to perform a laminectomy, discectomy, or spinal fusion to relieve your back pain while you focus on recovery. By understanding the need for general anesthesia, the expectations of local infiltration, the measures we take to manage blood loss safely, and the expected hospital stay, you can approach your surgery with greater preparation and peace of mind. Your anesthesia team is here to support you every step of the way, ensuring a safe and comfortable experience as you begin your journey to better mobility and health.
If you have more questions or want to learn about anesthesia for other procedures, explore this website or talk to your healthcare team. Leave a comment or send me a message. I’m here to help you feel ready and at ease because, as you know, prepared patients have better outcomes!
Curious about ways to set yourself up for successful back surgery? Click the image below to read 5 Steps to Prepare for Surgery: Surgery Preparation Guide
Want to learn more about anesthesia or find the type of anesthesia commonly used for different surgeries? Click the worryfreeanesthesia.com icon below to search the Articles list.
**Information provided is intended as general healthcare information for the public and should be used as a guide. This information should not be substituted for the specific personal advice recommended by your own healthcare team who are familiar with your specific health history.*
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