Epidural Anesthesia: Relievin... Health Article

The spinal cord is the main pathway for pain signals. These signals travel from nerves in your body through the spinal cord to your brain. The brain then registers them as pain. Anesthetic blocks the signals in the spinal cord before they reach the brain. That way you don't feel pain.

Numbing Your Lower Body

An epidural blocks the nerves that enter your lower spine. Anesthetic is injected into the space between the bones in the spinal column (vertebrae) and the covering around the spinal cord. This is called the epidural space. The anesthetic partly numbs your body from about the waist down into your legs. You stay awake, and you still have feeling in your upper body.

What Is Epidural Anesthesia?

Epidural is a kind of anesthetic (medication to block pain). It is commonly used during labor and delivery because it numbs your lower body while allowing you to remain awake. During an epidural, anesthetic is injected into the area around your lower spine outside the spinal fluid. Within minutes, your body becomes partly numb from about the waist down. You may lose muscle control in your legs, but you can usually still push during contractions. Little, if any, of the anesthetic reaches your baby. An epidural can be used for both vaginal delivery and cesarean (C-section) delivery. An anesthesiologist (a medical doctor) or a nurse anesthetist (CRNA) starts the epidural and monitors you throughout your labor and delivery. He or she will talk with you about the anesthetic and what to expect.

During Labor and Delivery

An epidural is usually not started until you're in active labor. You'll be asked to sit on the edge of the bed or lie on your side. First a small area around your lower spine is numbed with a local anesthetic. The anesthesiologist or nurse anesthetist then inserts a needle into the epidural space. A tiny plastic tube (catheter) is threaded through the needle. The needle is removed, and the anesthetic is delivered through the catheter. Sometimes a pump is attached to the catheter. The pump gives you a constant level of anesthetic throughout labor and delivery. During this time, your blood pressure and heart rate and your baby's heart rate are also closely watched.

Risks and Possible Complications

Your anesthesiologist or nurse anesthetist will discuss the risks and possible complications of epidural with you. These include:

• A sudden drop in blood pressure, which may slow the baby's heartbeat for a short time

• Severe headache which may last several days

• Very rarely,  dizziness, seizures, breathing problems, allergic reaction to the anesthetic, nerve damage, or paralysis

After Delivery

The epidural catheter is removed shortly after delivery, unless you need more pain medication after a C-section. You'll need to rest in bed until the anesthetic has worn off and you have normal feeling in your legs again. This usually takes 2-4 hours. Until you have fully regained use of your muscles, you may need a urinary catheter in your bladder.

Going Home

You'll likely be ready to go home 24-48 hours after delivery. If you had a C-section, you may stay in the hospital longer. You may feel some pain around the injection site for a few days. In rare cases, this lasts a month or more. If you have a headache or numb-ness in your legs, call your healthcare provider. As you recover from delivery, you can look forward to bonding with your new baby.