Lahey Health is now part of Beth Israel Lahey Health

by Lucey JR
(Peridural Anesthesia; Regional Anesthesia; Epidural)

Definition

Epidural anesthesia is a medicine placed into the space around the spinal cord. It will block sensation in the belly and legs.

Epidural Injection
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Reasons for Procedure

An epidural is used to decrease pain during labor. It blocks pain but does not put you to sleep. This allows you to interact with the care team.

After an epidural, you should no longer be able to feel:

  • Intense pain with your labor contractions
  • Lower back pain
  • Episiotomy (if needed) or vaginal tears from labor
  • Incision in your abdomen, if cesarean section (C-section) is needed

Epidural is not appropriate for everyone. You cannot have epidural anesthesia if the following occurs:

  • Low platelet counts
  • Blood is too thin because of blood thinners
  • Bleeding (hemorrhaging) or you are in shock
  • Serious infection in your back or blood
  • Labor is moving too fast and there is no time to place the catheter to administer the drug

Possible Complications

Epidural can make it hard to feel contractions or the urge to push. This may lead to a longer labor. The medicine may need to be decreased. Other medicine may help to increase sensation.

An epidural can lower the mother’s blood pressure. This can affect the amount of oxygen that reaches you and your baby. The baby’s heart rate will be watched closely. Breathing problems can also happen if the medicine affects nerves linked to breathing.

Epidurals can cause headaches after treatment. This can be treated.

What to Expect

Prior to Procedure

Your blood pressure, heart rate, and breathing rate will be monitored. Your baby's heart rate will be checked. IV fluids will be started.

Description of the Procedure

You will be asked to lay on your side or sit. You will be asked to arch your back and remain very still. The area around your waistline on your middle back will be wiped. It is an antiseptic that can to reduce the chance of infection. An anesthesia medicine will be injected into the area. It will make it numb.

A needle will then be inserted into your lower back. A small tube will be threaded through the needle. It will be passed into the space around your spinal cord. The needle will be removed and the catheter taped to your back. The medicine will be given through the catheter. More medicine may be given through the tube so that the numbness lasts until the baby is born.

Immediately After Procedure

After the tube is placed you will be asked to move from side to side. You may have the following side effects:

  • Shivering
  • Ringing in your ears
  • Backache
  • Soreness where the needle is inserted
  • Nausea
  • Difficulty urinating

How Long Will It Take?

It will only take a few minutes to place the tube. You should feel some pain relief within a few minutes. The full effect should happen within 20 minutes.

How Much Will It Hurt?

You may feel some pressure as the needle is being inserted.

Post-procedure Care

At the Care Center

You and the baby will be closely watched for changes. Other care for delivery will continue.

A tingling feeling may be felt as the anesthesia is wearing off. You may need help to walk until the anesthesia wears off completely.

Call Your Doctor

The epidural will have worn off before you go home. Call your doctor if you have:

  • Lingering or worsening back pain
  • Severe headache
  • Signs of infection such as redness or swelling

RESOURCES

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

The American Congress of Obstetricians and Gynecologists  http://www.acog.org 

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada  https://sogc.org 

Women's Health Matters  http://www.womenshealthmatters.ca 

References

Comfort measures (pharmacologic) during labor. DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T116857/Comfort-measures-pharmacologic-during-labor . Updated August 13, 2018. Accessed January 2, 2019.

Whitley N. A Manual of Clinical Obstetrics. Philadelphia, PA: JB Lippincott Company; 1985:343:619-621.

Revision Information