What is epidural anaesthetic?
Epidural anaesthesia is the term used to describe the blocking of nerve routes from the spinal cord with a local anaesthetic or pain-killing medication. It is also known as an anaesthetic of the nerve roots. It is commonly used in childbirth to alleviate labour pains, and in recent years has also been used in surgical operations to prevent post-operative pain and also to reduce complications such as chest infections and blood clots in the legs.

In childbirth, the epidural anaesthetic is usually started during labour and given before the neck of the womb has started to dilate. It is fully effective in around 96 per cent of cases, and up to 40 per cent of women in UK hospitals have an epidural while giving birth. However, the figure varies considerably from centre to centre.

How does the epidural anaesthesia work?
An epidural anaesthetic blocks the nerve roots that lead to the uterus and lower part of the body. These roots are located in a space near the spinal cord called the epidural space. This lies within the spine just outside the outer covering of the spinal cord.

How is an epidural anaesthetic given?
An epidural anaesthesia is always given by an anaesthetist. The anaesthetist locates the epidural space by inserting a thin hollow needle - usually into the lower part of the spine. A small plastic tube is then introduced into the back through the needle and left in position when the needle is removed. This tube is usually connected to an automatic pump, which is adjusted to introduce a certain amount of local anaesthetic and pain killing medication into the epidural space every hour.

What are the side effects?
The most frequent side effects are:

a drop in blood pressure. This occurs in most cases and is usually easily treated with drugs or by giving fluids through a drip. For this reason, the blood pressure must be checked at frequent intervals throughout the procedure.

headache (also known as a spinal headache). This happens to one per cent of patients who have been given an epidural and is due to the needle passing inadvertently into the spinal space. It can be treated successfully by an anaesthetist.

It is also recommended that extra care should be taken with the epidural anaesthetic if the woman has previously had a Caesarean section or a badly functioning placenta.

Can all women about to give birth get epidural anaesthesia?
Epidural anaesthesia has been used for many years, and is a safe and reliable technique. Patients will, however, receive full information in order to decide for themselves if they wish to go ahead with the procedure performed.

Complications such as meningitis can occur, but are extremely rare if adequate sterile precautions are used. The fear of permanent paralysis may exist in some patients' minds but again they can be reassured that this is an extremely uncommon occurrence. There are certain complications where epidural anaesthesia cannot be given such as back problems, infections, a tendency to bleed and nervous system diseases.

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