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Epidural anaesthesia - How an epidural is performed

NHS Choices Medical Reference

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If you choose to have an epidural, the procedure will be carried out by an anaesthetist. An anaesthetist is a doctor, specially trained in providing patients with pain relief during medical procedures.

Having an epidural

Most epidurals are given while the patient is sitting down and leaning forwards. Alternatively, an epidural can be carried out while you are lying on your side with your knees drawn up and your chin tucked in.

Lying or sitting in these positions opens up the spaces between the bones of your spine (vertebrae)  and allows the epidural needle to be passed into the epidural space more easily. This is an area through which the nerves from your spine to your body pass.

Before the epidural needle is inserted, a sterilising solution is rubbed into your back and sterile drapes are placed over your back, leaving the injection site exposed.

An injection of local anaesthetic into the skin helps to reduce any discomfort. A hollow needle is then inserted and a thin, plastic tube (epidural catheter) is passed through the middle of the needle, into the epidural space. The epidural anaesthetic can then be injected through the tube.

If you are having an epidural during childbirth, you will need to have a drip in your hand so that fluid and medication can be given to help prevent low blood pressure, a common side effect of epidurals. The drip may restrict you from moving around freely.

While you are having an epidural inserted, you may experience a brief stinging sensation as local anaesthetic is injected into the skin. You may also experience slight discomfort in your back when the epidural needle is positioned, and the catheter is inserted.

If you feel pain or an electric shock-like feeling, tell your anaesthetist, because the catheter may be pressing against the root of a nerve and may need to be repositioned.

Effects of an epidural

Shortly after having an epidural you will start to experience a warm, numbing sensation in your lower back and legs. Your legs may feel heavy and more difficult to move. It usually takes about 20-30 minutes for the epidural to take full effect.

The nerves in your bladder are also likely to be affected by the anaesthetic. This means you won't know when your bladder is full, and whether you need to go to the toilet. To prevent damage, a thin plastic tube (catheter) will be used to drain urine from your bladder. Your bladder sensation will return to normal when the epidural is stopped.

Read more about the side effects of an epidural.

After having an epidural

Following epidural anaesthesia, it is likely you will be advised to rest in a lying or a sitting position until the feeling in your legs returns.

It usually takes a couple of hours for the feeling to return to your legs and you may experience a slight tingling sensation on your skin as the anaesthetic starts to wear off. You may need help getting out of bed.

If you start to feel any pain, you should tell the doctor or nurse who is treating you. They will be able to give you medication to help control it.

After having an epidural you will be able to breastfeed your baby.

Medical Review: February 21, 2013
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