What is an epidural?
The epidural space lies just outside the special covering or dura, which encloses the spinal canal. An ‘epidural’ is a type of regional anesthetic in which a needle is positioned between the bones of the spine to allow the anesthesiologist to insert a small plastic tube (or catheter) into the epidural space. The needle is then removed and local anesthetic is injected through the catheter. This local anesthetic moves (or diffuses) across the dura. into the spinal canal, and temporarily stops the spinal nerves from working, so that sensation and movement in the area supplied by the nerves does not occur. When the effect of the local anesthetic wears off, sensation and movement will return. If a weaker solution of local anesthetic is used, then only painful sensations will be blocked. This is very useful for controlling pain and is called epidural analgesia. Often continuous infusions of local anesthetic solutions are used, which allows the effect to be maintained as long as required. The
Most people know of epidural analgesia as a way to keep women comfortable during childbirth. The epidural is a length of thin tubing that is placed in a space between the bones of the spine and the spinal cord. Medications can be given as an infusion to keep people comfortable after surgery. Children are generally quite afraid of needles and would move during catheter placement (which could be dangerous), so we place the catheter while the child is asleep under general anesthesia. Abdominal, chest, hip and leg surgery are the types of surgery most appropriate for an epidural. Epidurals can be used from the first day of life through adulthood.
An epidural is a potent steroid injection that helps decrease the inflammation of compressed spinal nerves to relieve pain in the back, neck, arms or legs. Cortisone is injected directly into the spinal canal for pain relief from conditions such as herniated disks, spinal stenosis, or radiculopathy. Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.
