Epidural Anaesthesia: When Is It Needed?

What Is Epidural Anaesthesia?

An epidural anaesthesia is a procedure whereby medication is injected into your back to block pain in a specific area of your body.

How Does Epidural Anaesthesia Work?

The spinal cord connects all your nerves to the brain. It is encased in a fluid-filled epidural space. When you have an injury, for example, the nerve in that region of your body sends a pain signal to your brain through your spinal cord.

During an epidural procedure, once the epidural anaesthetic or pain relief medicine is injected into the epidural space, it momentarily numbs the spinal nerves and prevents pain signals from travelling from your spine to your brain.

What Is the Difference Between Epidural Anaesthesia and Spinal Anaesthesia?

Epidural anaesthesia is commonly utilised during labour and delivery, including caesarean sections, as well as pelvic and lower extremity surgery. Additionally, it can be utilised alongside general anaesthesia for thoracic, abdominal, and pelvic surgeries, as well as for pain relief after these procedures.

During epidural anaesthesia, your doctor injects medicine into the space just outside of the sac of fluid that surrounds your spinal cord (epidural space). The medicine usually requires 20-30 minutes to have a full effect.

Spinal anaesthesia is frequently used for procedures involving the lower extremity, lower abdominal, pelvic, and perineal procedures. During spinal anaesthesia, the doctor injects medicine into the cerebrospinal fluid (CSF) to block pain.

Who Performs Epidural Anaesthesia?

Epidural anaesthesia is administered by an anaesthesiologist (a specialist doctor).

How Is Epidural Anaesthesia Performed?

The steps involved in an epidural anaesthesia procedure include:

• A drip will be inserted in your arm so that you can get fluids while receiving the epidural.
• You can either lie on your side with your knees drawn up to your chest or sit down and lean forward.
• To numb the skin where the epidural will be inserted, a local anaesthetic will be injected. This is done to reduce your pain when the epidural needle is inserted, which is usually larger than a standard injection needle.
• A needle is utilised to place a thin plastic tube known as an epidural catheter into your back, near the nerves responsible for transmitting pain signals to your brain. 
• Once the needle is withdrawn, only the catheter remains in your spine. 
• You might experience slight discomfort during the positioning of the epidural needle and insertion of the catheter.
• The catheter is then used to administer pain relief medicines, which usually take about 20-30 minutes to have a full effect.
• While the epidural drugs are being administered, your chest, stomach, and legs may feel numb.
• When you no longer need the epidural, your doctor will remove the catheter, clean the area with antiseptic, and cover the wound with a dressing.

How Long Does an Epidural Last?

It depends on what kind of epidural and medicine that you received:

• An epidural with a catheter: Your doctor may administer a continuous flow of anaesthetic drugs or multiple separate doses, based on your condition. After your doctor has ceased the drug, you will most likely experience numbness for a few hours before the medication’s impact wears off.

What Are the Pros and Cons of Getting an Epidural?

The advantages of getting an epidural analgesia include:

• Effective in reducing pain, such as during labour and delivery.
• It is a safe procedure.
• Less nausea and vomiting and quicker recovery time when compared with general anaesthesia.
• Lower risk of developing deep vein thrombosis (blood clot in your leg’s veins) when compared with general anaesthesia.

Although epidurals are excellent for managing pain, there are risks of certain side effects and complications involved in the procedure.

Side effects of epidural anaesthesia may include:

• Low blood pressure (may cause lightheadedness).
• Severe headache.
• Infection from the epidural procedure.
• Bleeding.
• Nerve damage at the injection site.
• Temporarily losing control of one’s bladder and bowels.

Who Should Get Epidural Anaesthesia?

Epidural anaesthesia is helpful in these groups of patients:

• Caesarean section epidural anaesthesia: An epidural is favoured for the majority of caesarean deliveries. This is because the baby is exposed to the least quantity of medication, and the mother can actively engage in the birth of the baby.
• Epidural anaesthesia for normal delivery: Epidural anaesthesia is the most common type of pain management during normal labour.As the medicine has a localised effect, mothers will be awake and attentive during labour and delivery. 
• Other indications: Epidural anaesthesia is also used for pain relief in patients undergoing thoracic surgery, abdominal surgery, and pelvic surgery.

Who Should Not Get an Epidural?

Individuals with the following conditions may not be able to have an epidural:

• Allergy to anaesthetic medication.
• Blood clotting issues.
• Having an infection.
• Specific neurological conditions or spinal cord abnormalities.

Make an Appointment at Pantai Hospitals

Epidurals are reliable and typically safe. However, like any medical procedure, there are potential risks and side effects. Ask your doctor any questions you may have if you are feeling nervous about getting an epidural. 

A dedicated and expert team of obstetricians and gynaecologists at Pantai Hospital is available for consultation to provide the best care and assistance. Get in touch with us to book an appointment today if you have any concerns or questions regarding epidurals.

Please contact the Health Screening Centre at your nearest Pantai Hospital for health screening appointments.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.