What is an Epidural?
- The spinal cord runs within the bony structure of the vertebral column and is encased by a membranous sac called the dural sac. This sac contains spinal fluid that nourishes and bathes the spinal cord. The epidural space is located between the outer surface of the dural sac and the bones of the vertebral column.
- Nerves from the lower limbs enter the vertebral column and pierce the dural sac to reach the spinal cord. These nerves can become irritated and cause pain in the lower limbs.
- An epidural injection or block is an injection of local anaesthetic and long lasting steroid into the epidural space. Occasionally a strong pain killing medication, such as morphine, may also be injected.
- It is thought that the steroid reduces the inflammation, irritation and/or swelling in the epidural space. This in turn reduces the pain, tingling, numbness and other symptoms associated with your pain condition.
- This procedure is always performed using an X-ray machine in the day surgery setting.
Prior to the Procedure
- All blood thinning products (except aspirin) must be stopped prior to your procedure. You will be advised by letter when to stop taking these medications at the time that your admission date is arranged.
- You are able to take your other regular medications with a sip of water on the morning of your procedure.
- If you are an insulin dependent diabetic you will always be at the beginning of the list. Please bring your insulin with you and it will be given to you following your procedure.
- Hamilton Day Surgery Centre staff will advise you of your fasting and admission times.
- You must not have anything to eat, drink, smoke or chew prior to your procedure.
- You will need to organise someone to drive you home after the procedure as you will not be able to drive for 24 hours after your procedure.
What Will Happen?
- You will be admitted to the day surgery by a nurse and you will be asked to change into a gown.
- The Anaesthetist will speak with you and place a cannula (plastic needle) into a vein in your hand.
- In the procedure room, you will be assisted to position on the procedure table lying on your abdomen with a pillow under your hips and abdomen.
- The Anaesthetist will give you some sedation into your vein. Some fluids may be administered via your cannula.
- An X-ray machine will be used to determine where the Doctor will place the needle for your procedure.
- Local anaesthetic will be injected into your back to minimise the discomfort felt when the spinal needle is inserted.
- The local anaesthetic and steroid will be injected once correct placement has been established with use of X-ray (Omnipaque).
- The procedure will take approximately 10 minutes to complete.
- After the procedure, you will be placed on a trolley and taken to recovery, where you will remain for approximately one hour.
- After having something to eat and drink, you will be discharged with a carer.
- Gentle activity and rest is recommended in the first 24 hours following the procedure. You may then return to normal activity.
- The local anaesthetic will wear off 12-18 hours following your procedure.
- The steroid will take approximately 48 hours to start working.
- During this time there may be a window of increased discomfort or pain.
- Occasionally, you may feel some leg heaviness or weakness. This is related to the spread of the local anaesthetic. Should this occur, it is advisable to keep you at Hamilton Day Surgery until sensation and power returns.
- A nurse from HPC will telephone you 24 to 48 hours following your procedure to check on your progress and organise a follow up appointment.
- You may obtain between 1 - 6 months of pain relief following your procedure.
If you require further explanation of the procedure, please contact Hunter Pain Clinic nursing staff on (02) 4985 1800.
* Image by BruceBlaus. (Blausen.com staff). "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. (Own work) [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons