Is an epidural anesthesia or analgesia?
Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body. The goal of an epidural is to provide analgesia, or pain relief, rather than anesthesia, which leads to a total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments.
Which types of medications are administered through the epidural catheter for pain management?
Epidural medications fall into a class of drugs called local anesthetics (examples include: bupivacaine, chloroprocaine, and lidocaine) and can be delivered in combination with narcotics (examples include: fentanyl and sufentanil) in order to decrease the required dose of local anesthetic.
What are the common medications used for epidural analgesia?
Epidural Analgesia and Anesthesia Bupivacaine and chloroprocaine are the drugs most commonly used, the former providing more prolonged anesthesia but with a greater delay in onset. Combinations of local anesthetics and narcotics also provide excellent analgesia with less motor blockade.
How is an epidural analgesic administered?
If you choose to have an epidural, a physician anesthesiologist will insert a needle and a tiny tube, called a catheter, in the lower part of your back. The needle is removed and the catheter left in place for delivery of the medication through the tube as needed.
When do you start epidural analgesia?
The anesthetic is usually administered after the diagnosis of active labor has been established and the patient has requested pain relief. Most patients do not request an epidural before cervical dilation of 3 cm, unless they are receiving oxytocin for labor augmentation.
What kind of anesthesia is used for epidural injection?
The injection is performed under local anesthesia and, on occasion, with intravenous sedation. Patients are not deeply sedated or completely asleep for this procedure because it is unnecessary and unsafe to do so.
What is the meaning of epidural analgesia?
Definition: epidural analgesia. epidural analgesia. Injection of a local anesthetic into the epidural space of the spine to prevent or eliminate pelvic pain.
What is postoperative epidural analgesia?
postoperative epidural analgesia is usually administered via a continuous infusion to maintain a level of analgesia and to minimize the cardiovascular and respiratory effects of bolus doses of LA and opioid respectively.
What are epidural analgesic contraindications?
Contraindications to the use of a neuraxial (i.e., epidural or subarachnoid) technique include patient refusal, active maternal hemorrhage, septicemia, infection at or near the site of needle insertion and clinical signs of coagulopathy (Table 2).
Is epidural a sedation?
Spinals and Epidurals are used very often at the Hospital for Special Surgery for any surgery below the waist. All of these blocks are performed once you have received some sedation through your intravenous line.
Is epidural injection painful?
You may feel some pressure during the injection. Most of the time, the procedure is not painful. It is important not to move during the procedure because the injection needs to be very precise. You are watched for 15 to 20 minutes after the injection before going home.
Where is epidural analgesia given?
An epidural anesthesia injection works by injecting an anesthetic into the epidural space around your spine so that it can stop pain signals from traveling from your spine to your brain. The epidural space is filled with fluid and surrounds your spinal cord. Think of it as a liquid sleeve around your spinal cord.
What are the benefits of epidural analgesia?
Epidural analgesia can reduce the incidence of postoperative pulmonary, thromboembolic and cardiac complications. As part of a multimodal recovery programme, epidural analgesia can enhance the quality of patient recovery from major surgery and shorten hospital stay.
What are complications of epidural analgesia?
Side effects Epidural
- Low blood pressure. It’s normal for your blood pressure to fall a little when you have an epidural.
- Loss of bladder control.
- Itchy skin.
- Feeling sick.
- Inadequate pain relief.
- Headache.
- Slow breathing.
- Temporary nerve damage.
Is epidural analgesia an opioid?
Epidural opioids have the advantage of producing analgesia without motor or sympathetic blockade. Studies have determined differences among the frequently used opioids for epidural analgesia. Onset of analgesia is more rapid with the highly lipid soluble opioids.
What is an epidural infusion?
A continuous epidural infusion is the placement of a temporary catheter into your spine used as a short screening trial for the intrathecal pump (“spinal pain pump”). This allows patients to use a much lower dose of medication to control their pain, therefore reducing side effects.
How is epidural catheter analgesia performed?
Epidural Catheter Analgesia. After the skin is anesthetized and spinous process located, an 18G Tuohy epidural needle ( Fig. 17-3) is placed in a perpendicular fashion to the skin. A small tilt of the needle tip in the cephalad direction may make catheter placement easier. Advance the needle through the skin, fascia,…
What is the role of epidural analgesia in the management of pain?
For surgical patients, epidural analgesia provides better pain management than systemic opioids, improves gastrointestinal function, reduces the risk of postoperative myocardial infarction, and may decrease the risk of postoperative mortality.
How does an intrathecal pump work in epidural analgesia?
An intrathecal pump delivers medications into the intrathecal space (also called the subarachnoid space), which is filled with cerebrospinal fluid (CSF). 2, 3 To better understand how epidural analgesia works, review the anatomy of the epidural space and the surrounding structures. (See Picturing the epidural space .)
What is the purpose of continuous epidural catheters during labor?
The use of continuous epidural catheters allows maintenance of labor analgesia for prolonged periods of time. Intermittent boluses (by physician or midwife) can provide satisfactory analgesia, but require constant availability of a clinician capable of providing analgesia.