What is epidural anesthesia?

An epidural (epidural catheter) is a tiny tube that puts pain medicine into an area in your back around your spinal cord. This is called the epidural space.

An epidural is often used during childbirth. But it may also be used during and after certain types of surgery. These include hip, knee, and gynecologic surgery.

During surgery, an epidural will numb you so that you don't feel pain. After surgery, medicine given through an epidural usually controls pain better than medicine by mouth or a vein.

You may have one or two types of pain medicines given through an epidural.

Analgesics relieve pain by decreasing pain signals from your surgery site to your brain. They do not affect your muscles or how well you can move. Fentanyl and morphine are common ones.

Anesthetics numb or dull feeling in a specific part of your body. They do affect your muscles and how well you can move. They also lower your blood pressure. Lidocaine and bupivacaine are common ones.

You may have an epidural for several hours or several days. Afterward, you may take pain medicine by mouth.

How is it done?

Before the anesthesia specialist places your epidural catheter, you may be given medicine through an IV in your vein. This will help you relax.

You will sit up and lean forward to expose your lower back. Or you will lie on your side with your knees curled up to your chest. Try to be as still as you can.

First the specialist injects a numbing medicine into the skin on your back. Then the specialist puts a needle into the numbed area. The catheter (a tiny tube about the size of a pencil lead) is inserted through the needle. You may feel some pressure as the catheter is placed. But you probably won't feel pain. If you do feel pain, tell your doctor.

The specialist then removes the needle. But the catheter stays in your back to supply the medicine. Usually this feels about the same as getting an IV.

After the catheter is in place, it is taped to your back. You will feel the tape, but you should not feel the catheter. As the medicine goes into the catheter, the tube may feel cold against your back.

The medicine or medicines will start to work in a few minutes. They will not put you to sleep. But they may make you feel a little tired. Your lower body may or may not feel numb. It depends on the type and amount of medicines you get.

You won't feel pain when the catheter is taken out. Then a nurse may press on the area with a bandage. This is to prevent bleeding.

What can you expect when you come out of surgery?

How long you need your epidural depends on the surgery you had and your level of pain. After your surgery:

• You may sleep a lot.
• For the first 24 hours, you may need extra oxygen. This is because some medicines can slow your breathing and lower the oxygen in your blood. You will get the extra oxygen through a tube in your nose or through a mask.
• A nurse will check your heartbeat and breathing often.
• Your doctor or nurse will ask about your pain often. They can adjust your medicine as you need it.
• You may be able to press a button to give yourself more medicine when you need it.
• If you had an anesthetic medicine, your legs may feel numb, tingly, or heavy. If your legs feel strange, don't try to get out of bed without a nurse to help you.
• You may have nausea, itching, or shivering. Your specialist or nurse may be able to give you medicine to help with these.