Epidural: What Is It & How Does It Work?

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“Epidural anesthesia for labor pain reduction is a form of anesthesia in which pain medicine is injected near the lower spine or backbone,” says Sangeeta Kumaraswami, M.D., an anesthesiologist specialized in obstetric anesthesia at Westchester Medical Center in Valhalla, New York. “It numbs the area below the injection, enabling a woman to stay awake and attentive but more comfortable throughout labor, and to feel pressure to push when the time comes to deliver her baby. It is also known as an epidural block or epidural injection.”

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How Does an Epidural Work?

An epidural anesthesia injection works by injecting an anesthetic into the epidural area around your spine, preventing pain signals from passing from your spine to your brain. The fluid-filled epidural area surrounds your spinal cord. Consider it a liquid sheath wrapped around your spinal cord.

Your spinal cord functions as a freeway, connecting nerves throughout your body to your brain. When you are hurt, for example, the nerve in that part of your body sends a pain signal to your brain and back via your spinal cord. An epidural anesthetic temporarily numbs the spinal nerves, which subsequently block pain signals in a specific region of your body based on where the epidural was administered along your spine.

Epidural anesthesia can give either transient pain alleviation or a temporary loss of sensation. The following factors influence how much feeling you briefly lose as a result of an epidural:

The type of anesthetic medicine used by your physician.
The drug’s concentration (how strong it is).
The medication’s dose.

An epidural steroid injection (ESI) operates in a slightly different way and is used to alleviate chronic pain. Instead of anesthetics, your practitioner will inject a steroid or corticosteroid medicine into the epidural area around your spine. Instead of suppressing pain or sensation in a specific area of your body, the steroid covers the irritated nerve(s) giving you discomfort and helps to lessen swelling. The steroid gives the nerve(s) enough time to recover. Pain alleviation with epidural steroid injections can be brief, long-term, or permanent.

What Are the Various Medicine Distribution Methods?

Spinal injection: According to Dr. Kumaraswami, a spinal injection is a single injection that can be administered alone or in conjunction with an epidural. “When used alone, it is delivered by a needle placed into the spinal canal in the lower back,” she explains. “While pain relief is instantaneous, it normally lasts between 1.5 and 3 hours and may wear off before the baby is delivered.”
Epidural injection: This type of injection allows for the extra implantation of an epidural catheter (which is threaded into your epidural space, as the needle is removed, and the catheter is taped to your back). According to Dr. Kumaraswami, the catheter remains in place for the duration of the labor. “As required, little dosages of the drug can be injected,” Dr. Hoskins explains. “This alleviation can endure for the course of labor (up to 24-36 hours) as well as for many hours afterwards. Epidural analgesia is also used to treat persistent pain that might linger for several days.” It is also worth mentioning that epidural pain medication may be targeted to a specific region, whereas spinal pain relief is more widespread.Some hospitals provide a “walking epidural,” which allows you to get out of bed. “You may not be permitted to walk once the epidural is in place owing to safety and monitoring concerns,” Dr. Kumaraswami cautions.

If you require a cesarean section or tubal ligation after the baby is delivered, the epidural medication can be continued during these operations.

Are There Any Dangers or Negative Effects?

Epidurals are highly safe, with relatively few significant consequences. However, there are possible negative effects, like with any drugs and medical procedures:

Blood pressure reduction – The medicine may drop your blood pressure, which may cause your baby’s heart rate to slow. To reduce the likelihood of this, you may be given additional fluids through an IV in your arm and may be required to rest on your side. Your physician anesthesiologist may occasionally provide a blood pressure medicine to you.
Painful back – The area of your lower back where the needle was put to give the medicine may be sore. This discomfort should only last a few days. There is no indication that an epidural can result in long-term back discomfort.
Headache – On rare circumstances, the needle pierces the covering of the spinal cord, causing a headache that can last for many days if not addressed. If this occurs, consult with your physician anesthesiologist about your treatment options.

Who Isn’t a Candidate for an Epidural?

There are several circumstances that may make getting an epidural risky:

Allergies to anesthesia drugs

Problems with blood clotting

A contamination

Diabetes that is uncontrolled

Other drugs you’re taking Depending on your condition, your doctor may recommend another sort of pain management for you, or you may need to postpone the surgery until a better time comes along.

What is the Distinction Between Epidural Anesthesia and Epidural Analgesia?

Analgesia is pain alleviation that occurs without the loss of awareness (sleep) or total loss of feeling or movement. Epidural analgesia is used by anesthesiologists to relieve pain during childbirth. The epidural is injected into your lower back to relieve discomfort in the bottom portion of your body caused by contractions and birthing.

Anesthesia is defined as the lack of bodily feeling with or without awareness. Epidural anesthesia will not cause you to lose consciousness, but if you’re having a certain type of surgery, your anesthesiologist may give you epidural anesthesia so you don’t feel any pain or move throughout the procedure, as well as another medicine to put you to sleep (lose consciousness).

What is the Purpose of Epidurals?

Your doctor may advise you to have an epidural in the following circumstances:

To relieve discomfort (analgesia) during labor and delivery.
To give anesthesia as an alternative to general anesthesia for certain procedures.
To alleviate pain following certain procedures.
To treat specific causes of back pain and other types of chronic pain (through epidural steroid injections).

Can Epidurals Cause Harm to the Baby?

The quantity of medicine delivered to the infant by the epidural is minute, and there is no evidence that it causes harm.

Can an Epidural Have Long-term Consequences?

While it is extremely unusual, having an epidural treatment might result in several long-term consequences, such as:

Permanent neurologic disability as a result of the epidural injection-caused spinal cord or nerve root injury.

Chronic pain as a result of spinal cord or nerve root injury caused by the epidural injection.

A hematoma causes permanent paralysis when blood accumulates between the dura mater and the spinal cord.

Can Having an Epidural Induce Back Pain?

It’s a frequent misconception that having an epidural can induce back pain, but it’s extremely unusual for an epidural to create long-term or chronic back issues.

It is typical to suffer brief back discomfort or soreness at the epidural location. This normally resolves itself after a few days.

This idea is most likely based on the reality that many women who give birth have back discomfort following labor and delivery, whether they had an epidural or not. This is because the bones and ligaments in your pelvis are moving back into their pre-pregnancy positions, causing back pain and discomfort.

Conclusion

Epidurals are a frequent, effective, and typically safe method for providing immediate pain relief and/or a temporary loss of sensation. If you’re worried about getting an epidural, don’t be hesitant to question your healthcare practitioner about it and the process. They are there to answer any inquiries you may have.