Epidural anaesthesia

Reviewed by Dr Gordon F N Smith, consultant anaesthetist



Epidural anaesthesia is the term used to describe the blocking of nerve routes from the spinal cord with a local anaesthetic or painkilling medication. It is also known as an anaesthetic of the nerve roots.

It is commonly used in childbirth to alleviate labour pains.

In childbirth, 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.

Epidural statistics

Up to 40 per cent of women in UK hospitals have an epidural while giving birth.

However, the figure varies considerably from hospital to hospital

How does 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 given?

An epidural anaesthetic 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 painkilling 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, your blood pressure must be checked at frequent intervals throughout the procedure.

headache (also known as a spinal headache). This happens to 1 per cent of women who have an epidural and is due to the needle passing into the spinal space. It can be treated successfully by an anaesthetist. This type of headache can be severe and last more than 24 hours, requiring total rest and strong analgesia.

It's also recommended that extra care be taken with an epidural if you've previously had a Caesarean section or a badly functioning placenta.

Other uses

In recent years, epidurals have been used in surgical operations to prevent post-operative pain and to reduce complications such as chest infections and blood clots in the legs.

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