Introduction of epidural anaesthesia

Epidural anaesthesia, often referred to as an epidural, is an injection into the lower back that numbs the nerves and stops you feeling pain.

The areas that can be numbed by an epidural include the:

• chest (thoracic area)
• abdomen
• pelvic area
• legs

How an epidural works

During an epidural, an anaesthetist uses a fine needle to carefully inject anaesthetic medication into an area of the spine known as the ‘epidural space’. An anaesthetist is a doctor specially trained to provide pain relief during surgical procedures.

The anaesthetic works by blocking the nerve roots in the spine that lead to the lower part of the body. The extent of the numbness will depend on the type of anaesthetic used and the amount injected. Once the medication has worn off, the feeling in the affected areas will return.

Read more about how an epidural is performed.

When is an epidural used?

An epidural can be used to provide pain relief in a number of different situations including:

• during natural childbirth
• during a Caesarean section 
• after surgery that has been carried out under general anaesthetic (where you are unconscious during the operation)

Read more about why an epidural is used.

This topic focuses mainly on having an epidural during labour and childbirth.

Safety

Epidurals have been routinely used for many years and are widely accepted as an effective method of providing pain relief after surgery and during labour and childbirth.

However, as with many medical procedures, there are some associated risks that, although small, you should be aware of before deciding whether to have an epidural. Two possible risks include:

• puncture of the dura – the dura is the thickest, outermost layer that surrounds the spinal cord and brain; the risk of the dura being punctured is about 1 in 100 
• infection – which can very rarely occur in the weeks following an epidural; the risk of this occurring is about 1 in 47,000

Read more about the complications of an epidural.

Effectiveness

Although epidurals are commonly used to provide pain relief, they are not always effective at reducing labour pain. The Obstetric Anaesthetists Association estimate that 1 in 8 women who have an epidural during labour need to use other methods of pain relief.

Read more about the side effects of an epidural.