Injections called epidurals are used to administer anaesthesia or reduce pain close to the spinal cord. Epidural injections come in two varieties. Both are secure and efficient. Which type you'll require and what to anticipate will be determined by your healthcare provider. Although they are uncommon, side effects and problems are possible.

What is an epidural?

An epidural is a painkiller that is injected into the area surrounding your spinal nerves. The epidural space is this region. That is the origin of the term "epidural."
Epidurals can be used to manage a variety of issues, including:

• Labor pain relief
• Before surgery, as an anesthetic
• Pain relief after surgery
• To treat back pain from issues like herniated disks
• Chronic pain management

Types of epidurals

There are two types of epidurals healthcare providers use for different situations:
Epidural anesthesia. Anesthesia blocks feeling and pain. Epidural anesthesia is an injection of anesthetic medication into your epidural space.
Epidural steroid injections (ESI). ESIs manage chronic pain and inflammation. A healthcare provider will inject a steroid (corticosteroid) into your epidural space. ESIs last longer than anesthetic epidurals. They manage pain for weeks or months.

How does an epidural work?

The sort of epidural you require determines how it functions.
An epidural anaesthesia prevents pain signals from reaching your brain from your spinal nerves. It momentarily and securely shuts off the nerves. The dosage that your doctor prescribes will determine how long the impact lasts.

Injections of epidural steroids coat the inflamed nerves that are producing pain. This lessens the pressure and swelling on the nerves that are impacted.
Your doctor can use an epidural to administer medication in a number different ways, such as:

• epidurals with a single injection. These are one-time steroid or anaesthesia injections. The majority of epidural steroid injections are administered in this manner. using a catheter for epidurals. Your healthcare professional will insert a catheter—a tiny, flexible tube—into your epidural area. This enables them to administer several doses of your medication in one location. These are most frequently used to relieve labour pain and provide anaesthesia during lengthy procedures.
• patient-controlled analgesia (PCA) combined with an epidural. Following surgery, your doctor will leave these specialised catheters in your epidural area. You'll be able to regulate when you receive painkillers with a portable gadget. You may select when to take safe, regulated doses of painkillers thanks to the pump.
• CSE stands for combined spinal-epidural. A combination of anaesthesia and a steroid administered via catheter is known as a CSE. CSEs are typically used to relieve labour discomfort. This type of epidural is often called a “walking” epidural, but most people aren’t able to fully walk. Rather, you will likely be able to move or shift postures and have some feeling in your lower body.

Treatment Details

How should I prepare for an epidural?
Depending on the kind of epidural you're getting and why you need it, there may be different preparations you need to make. You will receive detailed preparation instructions from your healthcare professional.
In general, you might have to:
Fast (avoid eating and drinking) for several hours before your procedure. Stop taking medications or over-the-counter supplements (especially if you take blood thinners). Plan ahead for someone to drive you home.

• Fast (avoid eating and drinking) for several hours before your procedure.
• Stop taking medications or over-the-counter supplements (especially if you take blood thinners).
• Plan ahead for someone to drive you home.

What happens during an epidural?

The sort of epidural you require determines what happens during the procedure.
You will lie face down, or on your stomach, if you require a single-injection epidural. Your supplier will:

1. To make the area where the epidural is needed numb, inject a tiny quantity of local anaesthetic.
2. Guide them with fluoroscopy as they administer the epidural
3. Inject the drug using a needle into the epidural space close to the afflicted nerves.
4. Take out the needle and cover the injection site with a bandage and dressing.

The process will be slightly different if you require an epidural with a catheter. Regarding these, your supplier will:

1. Insert an IV fluid port into a vein in your arm;
2. Have you sit up or lie on your side with your chin tucked in towards your chest; and
3. Administer a local anaesthetic close to the epidural site.
4. Place the epidural needle in your epidural area.
5. Insert a catheter through the needle.
6. Take out the needle, leaving the catheter in place.
7. Start using the catheter to administer medication.
8. After you stop taking your medication, which could be a few hours or days later, remove the catheter.

What will I feel during my epidural procedure?

When your physician administers the local anaesthetic to numb the area prior to the epidural operation, you may feel a slight pinch.
When the epidural is injected, you can experience pressure, tingling, a burning feeling, or a brief shooting pain. Or you might not experience any emotions. Any discomfort you may have during the injection normally goes away when it is complete. .
If you have severe, sharp pain during or after your epidural operation, let your provider know right away.

What happens after an epidural?

Anesthetic-infused epidurals take 20 to 30 minutes to take effect. If you are in labour or undergoing surgery, your healthcare provider will explain the following steps. .
Injections of epidural steroids begin to act within a few days. A few months should pass before the soreness subsides.

Risks / Benefits

What are the benefits of having an epidural?

Epidurals are a secure and efficient method of administering anaesthesia or managing pain. Particularly during labour, anaesthetic epidurals offer greater flexibility than other forms of anaesthesia. If you require an epidural, you can often have one at any point throughout your labour. Compared to other forms of anaesthesia, they frequently have less severe side effects. You can continue daily activities that you were unable to do due to pain with the help of epidural steroid injections. You may be able to avoid surgery or other intrusive treatments if it effectively treats your pain. Advertisement

What are the risks of getting an epidural?

Although epidurals are generally safe, there is a chance of some problems and negative effects. Risks and complications, however uncommon, can include:

• At the injection site, bleeding
• Rarely, cerebrospinal fluid leaks occur.

Infections at the injection site; damage to the nerves that could result in persistent pain; adverse responses to steroids or anaesthesia; and spinal cord injuries Can back issues result from receiving an epidural? .
Despite the widespread misconception that receiving an epidural will result in back discomfort, prolonged or chronic back issues are extremely uncommon. Temporary back soreness or tenderness where your epidural is located is common. Usually, this disappears after a few days.
Whether or not they had an epidural, many women who give birth have back pain following labour and delivery. This occurs as a result of your pelvic bones and ligaments returning to their pre-pregnancy locations. Temporary back pain and discomfort may result from this.

Recovery and Outlook

How long does an epidural last?

The type of epidural you received and the specific medication your doctor injected will determine how long the effects linger. You will be informed of what to anticipate by your provider.

• It typically takes a few hours after a single-injection epidural for you to feel normal again in the numb area. Injections of epidural steroids typically relieve pain for three to six months.
• After receiving a catheter-assisted epidural, you usually experience numbness for a few hours until the effects wear off. Until your legs feel completely normal again, you'll most likely need to rest and not move. While you wait, you can get a mild tingling sensation.

When can I resume my normal activities?

After receiving an epidural, avoid driving, operating machinery, and consuming alcohol for at least 24 hours. Following an epidural, you may need to refrain from specific physical activities and exercises for a day or two. You will receive detailed instructions from your healthcare practitioner regarding when you can resume your regular activities.

When To Call the Doctor

When should I call my healthcare provider?

If you have any of the following symptoms following an epidural, contact your doctor or visit the emergency room:

• Fever
• Inability to regulate your bowel movements (faucal incontinence) or urine (urinary incontinence)
• A severe headache that gets better after lying down; numbness and/or weakness in your legs that persists longer than your doctor recommends.

A note from Cleveland Clinic

Receiving an injection close to your spinal cord may seem frightening. However, epidurals are a popular, secure, and efficient method of administering anaesthesia or pain management. Do not hesitate to ask any questions you may have of your healthcare provider. They can provide you with all the information you require. They will describe the optimum kind of epidural for you, the drug they intend to administer, and the duration of the effects.

Care at Cleveland Clinic

Experts in childbirth at Cleveland Clinic guide you through every stage, from labour and delivery to what to anticipate when you and your baby return home.