Epidural

An epidural is a catheter that delivers medicines to the nerves near your spine. It is used to control your pain after surgery. The epidural (small plastic tube) is placed in your back. The tip of the catheter rests in the area just outside the spinal cord. This area is called the epidural space. Medicines are injected through the catheter into the epidural space to control pain. The epidural will be placed before your surgery.

Your anesthesiologist will insert the catheter and give you the pain medicine.

Using an epidural means you will need less narcotic pain medicine. This will help reduce side effects such as nausea, vomiting, constipation and itching. You will also be less sedated so you can take an active role in your recovery.

During the procedure

• You will sit and bend over or lie on your side.
• Your back will be carefully cleaned.
• The anesthesiologist will numb your skin. You may feel a slight burning (like sunburn) for a few seconds.
• Once your skin is numb, the anesthesiologist places a special epidural needle into your back and into the epidural space. This space is just outside the spinal cord. (See the illustration on this page.)
• He or she threads the catheter through the epidural needle into the epidural space.
• The anesthesiologist removes the epidural needle and tapes the catheter to your back.
• The catheter will come up over your shoulder so the nurses or doctors have easy access to it.
• You will be able to lie on the catheter.

After the procedure

• Pain medicine enters your body through this catheter. The medicine can be given continuously (without stopping) as well as from time to time
• You may also receive other pain medicines in addition to the epidural. Your anesthesiologist will prescribe what is right for you.
• The catheter will be left in place for 24 to 48 hours. You may need it for a longer period of time.

Benefits

Using an epidural will allow you to:

• have better pain control
• be up walking sooner after your surgery
• be able to eat a regular diet sooner after surgery
• be able to go home sooner after surgery

Side effects of an epidural

• You may get a headache. 
• Your lower back may become tender at the catheter entry site.
• Your blood pressure may drop at times.

Very rare complications (problems) include:

• bleeding around your spinal cord
• infection near your spinal cord
• injury to your spinal cord

Other information

• The nurses will watch you closely during and after the medicine is given.
• Your nurse will place a pulse oximeter sensor on your finger when the epidural is in place. The sensor will record the amount of oxygen in your blood.

When to call your nurse

Call for a nurse if you have:

• nausea
• vomiting
• itching
• problems urinating
• changes in your pain/comfort level
• extreme back pain
• inability to move your legs