Epidural anesthesia is a method used to eliminate pain during certain procedures or surgeries. In this form of anesthesia, medication is injected inside the spinal column with a needle or thin tube.

Who is a candidate for the procedure?

An epidural, as the procedure is commonly called, is usually used for procedures performed below the rib cage. It is often the preferred way to reduce pain during childbirth. It can also be used for pain control after surgery or childbirth. Sometimes an epidural is used instead of general anesthesia if a person is very weak or sick.

How is the procedure performed?

A needle or special tube is inserted through the skin of the back until it enters the spinal column. Medication can then be injected into the spinal column. It is injected just outside the sac that contains the spinal cord. The medication acts on nerves that come from the spinal cord and carry pain messages to the brain.

An epidural is different from spinal anesthesia, a procedure in which the medication is injected inside the sac that contains the spinal cord. Epidurals are usually preferred for childbirth and are often better for pain control. Spinals require less medication and work faster, but they are more likely to cause headaches and low blood pressure.

Medication for epidural anesthesia may be given as a one-time injection with a needle. Another method is to put a special tube into the space around the sac inside the spinal column. This tube stays in place. If the surgery lasts a long time or pain medication is needed after surgery, more medication can be given through the tube.

The medication stops the sensation of pain and paralyzes the muscles, usually only below the rib cage. The amount of medication used can affect how far the numbness and paralysis extend through the body. The individual is generally awake during the procedure. Sedatives can be given if the person has anxiety.

Careful monitoring is done during the procedure. The oxygen levels in the blood, pulse, blood pressure, and other functions are monitored. Fluids are usually given through an intravenous line (IV) to prevent dehydration and low blood pressure. If a tube is inserted into the spinal column, it is removed when no longer needed.