Epidural anaesthesia - How an epidural is performed

If you choose to have an epidural, the procedure will be carried out by an anaesthetist. An anaesthetist is a doctor trained in providing patients with pain relief during medical procedures.

Having an epidural

Epidurals are given in the lower back area. Most are given while the patient is sitting down and leaning forwards. Alternatively, an epidural can be carried out while you’re lying on your side with your knees drawn up and your chin tucked in.

Lying or sitting in these positions opens up the spaces between the bones of your spine (vertebrae) and allows the needle to be passed into the epidural space more easily. This is an area through which the nerves from your spine to your body pass.

A sterilising solution is rubbed into your back and sterile drapes are placed over your back, leaving the injection site exposed.

An injection of local anaesthetic may be given to help reduce any discomfort. A hollow needle is then inserted and a thin, plastic tube (epidural catheter) is passed through the middle of the needle, into the epidural space. The epidural anaesthetic can be injected through the tube.

If you are having an epidural during childbirth, you will need a drip in your hand so fluid and medicines can be given to help prevent low blood pressure, which is a common side effect of epidurals. The drip may restrict you from moving around freely.

You may experience a brief stinging sensation as local anaesthetic is injected into the skin. You may also feel slight discomfort when the epidural needle is positioned, and the catheter is inserted.

If you feel pain or an electric shock-like feeling, tell your anaesthetist, because the catheter may be pressing against the root of a nerve and may need to be repositioned.

Effects of an epidural

Shortly after having an epidural you will experience a warm, numbing sensation in your lower back and legs. Your legs may feel heavy and more difficult to move. It usually takes about 20-30 minutes for the epidural to take full effect.

The nerves in your bladder are also likely to be affected by the anaesthetic. This means you won't know when your bladder is full, and whether you need to go to the toilet. To prevent damage, a catheter will be used to drain urine from your bladder. Your bladder sensation will return to normal when the epidural is stopped.

Read more about the side effects of an epidural.

How long does an epidural last?

While the epidural catheter remains in your back, it can be used to relieve pain. This can be for several hours (during labour) or for a few days, (after major abdominal surgery).

The catheter can be connected to an automatic pump to allow the medication to be topped up. Pumps that allow you to control the dose can also be used.

When the epidural drugs are stopped, the numbness usually lasts for a few hours before its effects begin to wear off, and feeling starts to return.

After having an epidural

Following epidural anaesthesia, you will probably be advised to rest in a lying or a sitting position until the feeling in your legs returns. This can take a couple of hours and you may feel a slight tingling sensation in your skins as the anaesthetic wears off.

Tell the doctor or nurse if you feel any pain. They can give you medicines to help control it.

After having an epidural, you will be able to breastfeed your baby.