The term epidural is often short for epidural anesthesia, a form of regional anesthesia
involving injection of drugs through a catheter
placed into the epidural space
. The injection can cause both a loss of sensation (anaesthesia
) and a loss of pain (analgesia
), by blocking the transmission of signals through nerves in or near the spinal cord.
Epidural anaesthesia requires a high level of technical proficiency to avoid serious complications, and should always be performed by a trained anaesthetist, using a strict aseptic technique
to reduce the risk of infection.
The patient may be in the sitting position or lateral position (lying on one side). The sitting patient is asked to slouch and bend forward slightly from the waist to increase the curvature of the spine. The lying patient is asked to draw the knees up to the chin for the same reason. Complications:
- No pain relief, also called block failure occurs about 1 in 20, or 5%. Additionally another 15% experience partial or 'patchy' blockade.
- Epidural slows down labor significantly- The following are accepted explanations for why this happens: ...
- The release of oxytocin is decreased with epidurals.
- Lack of downward pressure from the baby: Woman is lying down instead of standing up.
- Lower blood pressure- decreases oxytocin release.
- Malpositioning of the baby’s head to transverse or posterior.
- Decreased adrenaline release which may slow oxytocin release.