Epidural Procedure

The epidural procedure is a type of regional anesthesia that involves injecting medication into the epidural space surrounding the spinal cord to numb the lower part of the body. This procedure is commonly used for pain relief during childbirth, as well as for surgical procedures involving the lower back, hips, and legs.

How it Works

The epidural procedure involves the following steps:

• A local anesthetic is applied to the skin to numb the area where the needle will be inserted.
• A specialized needle, called a Tuohy needle, is inserted into the epidural space, which is located outside the sac that contains the spinal cord.
• A catheter, a small flexible tube, is threaded through the needle and into the epidural space.
• The needle is removed, leaving the catheter in place.
• Medication, such as anesthetic or pain relievers, is administered through the catheter to numb the lower part of the body.

Types of Epidurals

There are several types of epidurals, including:

• Combined Spinal-Epidural (CSE): This type of epidural involves injecting medication into both the spinal fluid and the epidural space.
• Walking Epidural: This type of epidural uses a lower dose of medication, allowing the patient to remain mobile and walk during labor or surgery.
• Low-Dose Epidural: This type of epidural uses a smaller amount of medication, which can reduce the risk of side effects and allow for more mobility.

Risks and Side Effects

As with any medical procedure, there are risks and side effects associated with epidurals, including:

• Headache: A headache can occur if the dura mater, a membrane surrounding the spinal cord, is accidentally punctured.
• Nerve Damage: There is a small risk of nerve damage, which can cause numbness, tingling, or weakness in the affected area.
• Drop in Blood Pressure: The medication used in an epidural can cause a drop in blood pressure, which can lead to dizziness or lightheadedness.
• Fever: Some patients may experience a fever after an epidural, which is usually mild and temporary.

Contraindications

Epidurals are not suitable for everyone, particularly those with certain medical conditions, such as:

• Bleeding Disorders: Patients with bleeding disorders, such as hemophilia, may be at risk of excessive bleeding during the procedure.
• Infection: Patients with an active infection, such as sepsis or meningitis, may not be suitable for an epidural.
• Allergy to Medication: Patients who are allergic to the medication used in an epidural may not be able to undergo the procedure.