What is an epidural?

An epidural anesthesia is a type of regional anesthesia that numbs a specific area of the body, similar to spinal anesthesia, but it can be more tightly controlled so that it provides a pain-reducing effect more specifically to the anatomical region desired. It is administered through a small catheter placed in the space surrounding the spinal cord, allowing continuous pain relief while you remain awake and alert. An epidural analgesia provides effective pain management without affecting your ability to stay conscious and communicate, making it an ideal choice when you need to be comfortable yet aware. Some examples of where epidural analgesia can be extremely useful and effective include patients having major abdominal or chest surgery or while giving birth. 

Anesthesiologist performing an epidural anesthesia injection.

How is an epidural different from spinal anesthesia?

Both epidural and spinal anesthesia involve anesthetic near the spinal cord to numb the lower part of the body. However, while spinal anesthesia is injected directly into the fluid around the spinal cord for rapid and complete numbness, an epidural involves placing a small catheter in the space outside the spinal cord ( the epidural space). This allows for a continuous infusion or repeated doses of anesthesia, providing more flexibility and prolonging the pain relief, which is especially useful during labor or longer surgeries. Importantly, epidural analgesia can be made more specific to the region of interest by placing the epidural at a different level of the spinal canal and by adjusting the dose of the epidural injection of local anesthetic. 

When is an epidural administered?

Epidurals are most commonly administered during labor and childbirth to help manage the pain of contractions while enabling mothers to participate actively in the delivery of their baby. They are also frequently used for surgeries involving the lower body, such as hip replacements or cesarean sections (C-sections), where numbing the lower half of the body is necessary, but general anesthesia is not required.

How long does it take for an epidural to start working?

It generally takes about 5-20 minutes for an epidural to start providing pain relief after it is administered. The sensation usually begins as a gradual numbness or loss of sensation in the lower body, allowing the patient to remain comfortable and alert. 

Can you move or walk around after getting an epidural?

It depends on the type and dosage of anesthetic used. Some “walking epidurals” allow for limited mobility, enabling some movement, such as standing or walking with assistance.  However, most epidurals will restrict movement to some extent due to the numbing effect on the lower extremities, and patients are generally advised to remain in bed for safety. 

Are there any potential side effects or risks associated with an epidural?

Common side effects of an epidural include:

• A drop in blood pressure
• Headache
• Itching
• Soreness at the injection site

Rare but more serious risks include infection, bleeding, nerve damage, or a severe headache if spinal fluid is accidentally punctured. An anesthesiologist will monitor you closely to manage any side effects and ensure a safe and comfortable experience.