Skip to main content

Anaesthesia · UK

Spinal Anaesthetic - awake, comfortable and often the safest option.

A well-established regional technique for hip and knee replacement, urology, gynaecology, Caesarean section and lower-abdominal surgery. A consultant anaesthetist, sedation on request, and honest counselling on what to expect.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a spinal anaesthetic costs privately in the UK.

Indicative anaesthetic fees.

In short

A consultant spinal anaesthetic for a hip replacement: £850–£1,600, on top of the surgical fee.

Anaesthetic service Indicative range
Anaesthetic pre-assessment £150–£300
Spinal anaesthetic (up to 90 min surgery) £650–£1,100
Spinal anaesthetic (90–180 min surgery) £850–£1,600
Spinal + sedation £1,100–£2,000
Combined spinal-epidural £1,400–£2,400
Epidural for labour £1,200–£2,200
Peripheral nerve block (adjunct) £300–£650

Anaesthetic fees are billed separately from the surgical fee. Duration is the main driver, along with whether sedation or a peripheral nerve block is added.

The problem

The right anaesthetic for the operation, not the default.

Spinal anaesthetic is often quietly better than a full GA - less blood loss, less nausea, better pain control. We make sure you get the choice, not just the default.

  • Awake, but not distressed

    Sedation is planned in advance if you prefer to be lightly asleep - you are not stuck with either extreme.

  • Better recovery for many operations

    Hip and knee replacement, TURP, Caesarean - spinal often means less blood loss, less nausea, faster mobilisation.

  • Honest counselling about headache

    Post-dural puncture headache is uncommon (under 1%) with modern fine needles, but real. We explain the risk before you consent.

When it helps

When spinal is the right choice.

The operations where spinal is a strong first choice, plus the situations where general anaesthetic is safer.

  • Hip and knee replacement

    Less blood loss, less nausea, faster mobilisation. The first-choice technique in many enhanced-recovery pathways.

  • Caesarean section

    The default anaesthetic for planned Caesarean - mother awake, immediate skin-to-skin possible.

  • TURP and ureteroscopy

    The gold standard - allows early detection of TURP syndrome and comfort during longer resection.

  • Hernia repair (open)

    Reasonable option for open inguinal or femoral hernia where GA is undesirable.

  • Prolapse and pelvic surgery

    Well-tolerated for vaginal and pelvic-floor procedures.

  • Lower-limb vascular surgery

    For amputations, femoral bypass and varicose vein surgery - often safer than GA in high-risk patients.

  • When GA is high-risk

    Severe respiratory disease, difficult airway, ischaemic heart disease - spinal is often the safer option.

  • Red flag: not for every patient

    Bleeding disorders, spinal deformity, some neurological conditions, patient refusal or infection at the puncture site preclude spinal. GA is the alternative.

Options

Spinal, epidural, combined spinal-epidural, or peripheral block.

What each option involves - timing, duration, and which operations they fit.

  • Single-shot spinal

    One injection into the CSF at L3/L4 or L4/L5. Fast onset (5–10 min), duration 2–4 hours. The default for most lower-body operations.

  • Epidural

    A catheter in the epidural space (outside the CSF). Slower onset, longer control via top-ups. Standard for labour analgesia and some abdominal surgery.

  • Combined spinal-epidural (CSE)

    A spinal for immediate block plus an epidural catheter for post-op top-ups. Useful for major hip surgery and Caesarean with expected long procedure.

  • Continuous spinal

    A catheter left in the CSF for prolonged block. Rare in the UK; used in specific high-risk cardiac cases.

  • Peripheral nerve blocks

    Add-on blocks (femoral, adductor canal, sciatic) alongside spinal or GA to give 12–24 hours of targeted post-op pain relief.

  • Spinal + sedation

    Light or moderate sedation with propofol alongside a spinal - awake but relaxed, no memory of the procedure.

  • General anaesthetic (GA)

    The default alternative. Chosen when spinal is contraindicated, unsuccessful, or you actively prefer to be asleep.

  • Local anaesthetic with sedation (MAC)

    Reserved for very short or superficial procedures - different from spinal, mentioned here for completeness.

Safety and recovery

What to expect afterwards - honestly.

Spinal anaesthetic is one of the safest anaesthetic techniques in modern practice. What to plan around: blood pressure, headache risk and the small chance of conversion to GA.

  • One of the safest techniques in anaesthesia

    Serious complications are rare. Consultant anaesthetists doing high volumes have very low complication rates.

  • Blood pressure drop is common but managed

    A modest drop in blood pressure is normal after insertion, and easily managed with fluids and vasopressors.

  • Post-dural puncture headache under 1%

    A distinct positional headache that develops in the first 48 hours. Treated with fluids, caffeine, simple analgesia and - occasionally - an epidural blood patch.

  • Failed or partial block is uncommon

    Around 1–3% of spinals fail or provide inadequate anaesthesia - we convert to GA if needed. That is not a complication, it is a plan.

  • Nerve damage is very rare

    Permanent nerve damage from spinal is well under 1 in 20,000 in modern practice. Transient back tenderness is common and settles in days.

  • Bladder emptying takes time

    The block affects bladder muscle. Passing urine may take longer post-op. A catheter is planned in advance for longer operations.

  • Not for everyone

    Contraindicated in bleeding disorders, some spinal deformities, active infection at the puncture site, and refused by the patient - GA is the alternative.

  • Sedation makes it comfortable

    If being awake worries you, sedation is planned in advance - you can be lightly relaxed or effectively asleep, at your preference.

  • Red flags after any spinal

    Severe positional headache, unusual back pain, fever, weakness or bladder problems need same-day contact with the anaesthetic team.

Reading your notes

Your anaesthetic chart in four parts. Read the last one first.

The anaesthetic chart keeps to the same shape whether spinal, epidural or GA.

A UK anaesthetist reviewing an anaesthetic chart

A quiet reminder

Clinical language is precise - we translate it if you would like.

If you would like us to talk you through your notes before your review, just ask.

  1. 01 Header

    Anaesthetic plan and consent

    What was planned and consented - spinal, epidural, combined, GA - and why.

  2. 02 Technique

    Insertion details

    Level of insertion, needle used, drug and dose administered, any peripheral block added.

  3. 03 Intra-op

    Physiology during surgery

    Blood pressure, heart rate, fluids and any intra-operative issues managed.

  4. 04 Plan

    Post-op pain and headache advice

    Read this first: pain plan, headache warning signs, mobilisation timing, and contact route for concerns.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Anaesthetic fees for spinal anaesthetic are usually covered when the surgical procedure is covered.

Frequently asked

Everything patients ask about spinal anaesthesia.

Quick answers on being awake, headache, recovery, cost and cover.

  • Will I feel the operation?

    No. Below the block level you will be completely numb - no pain, no sharp sensations. You may feel touch, pressure or movement, which is normal and expected. Nothing hurts. Sedation is planned in advance if you want to sleep through it.

  • What is the headache risk?

    Post-dural puncture headache occurs in under 1% of modern spinals using fine pencil-point needles. It is a distinct positional headache - worse standing, better lying - that develops in the first 48 hours. Most settle with fluids, caffeine and simple analgesia; a small minority need an epidural blood patch, which is 90%+ effective.

  • How long will my legs be numb afterwards?

    Motor block wears off over 2–4 hours. Full leg strength typically returns within 4–6 hours of insertion, at which point you can safely mobilise with the physiotherapy team. Bladder sensation may take a little longer.

  • How much does spinal anaesthetic cost privately in the UK?

    Consultant anaesthetist fees for a spinal typically range £650–£1,600 depending on the length of surgery, or £1,100–£2,000 if sedation is added. These fees are separate from the surgical and hospital fees. Insurance usually covers anaesthetic fees when the surgery itself is covered.

  • Can I choose between spinal and general anaesthetic?

    For most lower-body operations, yes - and we plan the choice at pre-assessment based on the operation, your medical history and your preference. Sometimes one is clearly safer than the other; in most cases both are reasonable and the choice is yours to guide.

  • What if the spinal does not work fully?

    Partial or failed spinals occur in 1–3% of cases. We test the block carefully before surgery starts. If cover is inadequate, we convert to general anaesthetic - a planned move, not an emergency.

Related treatments

Looking for something else?