Epidural Injection

3rd May 2006 at 11:50 BST by Dr.C.A.Jenner MB BS, FRCA. Permalink.

An explanation and description of Epidural Injections

What is an Epidural?

The word ‘Epidural’ refers to a space around the spine through which nerve roots leave the spinal cord, before travelling to the rest of the body.

An Epidural is a procedure in which a mixture of local anaesthetic and anti-inflammatory is administered into the epidural space.

The aim is to reduce inflammation and provide pain relief in the back.

The procedure is similar to that used for pregnant women, but different medications are used.

How is the Epidural performed?

Local anaesthetic is used to numb a small area of skin on the back.

A specially designed fine needle is carefully placed, with the tip in the Epidural space, using a standard loss of resistance to saline technique.

A solution of local anaesthetic and anti-inflammatory is administered into the Epidural space.

Sedation maybe used, particularly if patients are nervous.

The procedure takes around 15-20 minutes and is done as a day-case procedure.

With an effective Epidural, a patient can receive several months of pain relief.

This ‘Pain Free Window’ is the ideal time to rehabilitate the back, in conjunction with physiotherapy.

Rehabilitation is based on exercises and movements designed to help build a strong, healthy pain-free back.

What medications are used in an Epidural?

A mixture of a long-acting local anaesthetic (bupivicaine) and anti-inflammatory steroid (depo-medrone).

The anti-inflammatory steroid is a special preparation which is not absorbed by the blood stream and is not associated with the majority of serious side-effects that can be associated with other long-term oral steroid usage.

The steroid takes 4-10 days to have maximal anti-inflammatory and pain relieving activity.

Will I be cured with an Epidural?

Epidurals can be very successful in many patients at producing pain relief.

For those who get the benefits of pain relief, sometimes only one block is required.

For others, the relief lasts several months. Often these patients will have the procedure done 3-4 times per year to maintain their pain free window.

In other patients the technique may not be successful and other methods are used.

What are the adverse effects of an Epidural?

There may be some local discomfort from the administration of local anaesthetic.

Often there is a small bruise at the site of the procedure.

Occasionally patients get temporary numbness in the legs due to the local anaesthetic, which wears off after a few hours.

Infection is a possibility but rare as full sterile precautions are taken (sterile equipment/ gloves/ technique).

What preparation do I need to do?

Please tell staff if you are on warfarin or any other blood thinning drugs (aspirin, heparin, enoxaparin, etc).

It is essential you have an escort home after the procedure.