Epidural Anesthesia: General Explanation with General Anesthesia

This is a general explanation of epidural anesthesia.
This explanation assumes that it will be performed in combination with general anesthesia.

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What Is Epidural Anesthesia?

The brain and spinal cord are suspended in cerebrospinal fluid, which is enclosed by a tough membrane called the dura mater.
In epidural anesthesia, a very thin tube called a catheter is inserted outside the dura mater.

When and How Epidural Anesthesia Is Performed

Epidural anesthesia is considered safer when performed before general anesthesia takes effect.
Therefore, in most cases, it is done while the patient is still awake.

Just before general anesthesia takes effect, the patient may be instructed to turn to the side.

At this time, curling the back like a shrimp helps open the spaces between the vertebrae, making the procedure easier.

Epidural Procedure Steps

After the anesthesiologist confirms the position of the spine, the area will be disinfected.
Once the disinfectant dries, a sterile drape will be placed.

The anesthesiologist will then give a verbal cue before injecting a local anesthetic with a fine needle.
Once it is confirmed that the anesthetic has taken effect, the epidural anesthesia procedure will begin.

This procedure involves passing a needle through the spaces between the vertebrae to reach the area just outside the dura mater.
Because this is a highly delicate technique, it is important to remain as still as possible.

If any unusual sensations, such as a sharp, electric shock-like pain, are felt, inform the anesthesiologist immediately.

Once the needle is properly positioned, a catheter will be inserted and secured with tape or other means, completing the procedure.

Precautions and Contraindications

Precautions:
There are certain conditions under which epidural anesthesia may not be possible.
If any of these apply, communicate them to the anesthesiologist.

Additionally, if the spaces between the vertebrae are extremely narrow, the procedure may not be successful.
In such cases, alternative methods such as a nerve block may be used instead.

Risks and Complications of Epidural Anesthesia

Rare complications include:

• Epidural hematoma: Persistent bleeding outside the dura mater that compresses the spinal cord
• Nerve damage
• Local anesthetic toxicity

More common complications include:

• Severe pain
• Numbness
• Discomfort

If any of these occur, medical staff should be contacted immediately.

Conclusion

This concludes the explanation.
Thank you for your attention.