Epidural Injection
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- What is an Epidural?
- The word ‘Epidural’ refers to a space
around the spine through which nerve roots leave the spinal
cord, before travelling to the rest of the body.
- An Epidural is a procedure in which a
mixture of local anaesthetic and anti-inflammatory is
administered into the epidural space.
- The aim is to reduce inflammation and
provide pain relief in the back.
- The procedure is similar to that used for
pregnant women, but different medications are used.
- How is the Epidural performed?
- Local anaesthetic is used to numb a small
area of skin on the back.
- A specially designed fine needle is
carefully placed, with the tip in the Epidural space, using a
standard loss of resistance to saline technique.
- A solution of local anaesthetic and
anti-inflammatory is administered into the Epidural space.
- Sedation maybe used, particularly if
patients are nervous.
- The procedure takes around 15-20 minutes
and is done as a day-case procedure.
- With an effective Epidural, a patient can
receive several months of pain relief.
- This ‘Pain Free Window’ is the ideal time
to rehabilitate the back, in conjunction with physiotherapy.
- Rehabilitation is based on exercises and
movements designed to help build a strong, healthy pain-free
back.
- What medications are used in an Epidural?
- A mixture of a long-acting local
anaesthetic (bupivicaine) and anti-inflammatory steroid (depo-medrone).
- The anti-inflammatory steroid is a special
preparation which is not absorbed by the blood stream and is not
associated with the majority of serious side-effects that can be
associated with other long-term oral steroid usage.
- The steroid takes 4-10 days to have
maximal anti-inflammatory and pain relieving activity.
- Will I be cured with an Epidural?
- Epidurals can be very successful in many
patients at producing pain relief.
- For those who get the benefits of pain
relief, sometimes only one block is required.
- For others, the relief lasts several
months. Often these patients will have the procedure done 3-4
times per year to maintain their pain free window.
- In other patients the technique may not be
successful and other methods are used.
- What are the adverse effects of an
Epidural?
- There may be some local discomfort from
the administration of local anaesthetic.
- Often there is a small bruise at the site
of the procedure.
- Occasionally patients get temporary
numbness in the legs due to the local anaesthetic, which wears
off after a few hours.
- Infection is a possibility but rare as
full sterile precautions are taken (sterile equipment/ gloves/
technique).
- What preparation do I need to do?
- Please tell staff if you are on warfarin
or any other blood thinning drugs (aspirin, heparin, enoxaparin,
etc).
- It is essential you have an escort home
after the procedure.