What is an epidural nerve block?
An epidural nerve block is a procedure to block pain by injecting anesthetic medication into the epidural space. The epidural space is the area between the inner wall of the backbone (vertebral column) and the outermost of the three membranes (dura mater) that surround the spinal cord. The space between the inner two membranes (subarachnoid) is filled with cerebrospinal fluid.
The vertebral column is a series of interconnected bones that form a protective covering for the spinal cord. A part of the vertebra called lamina forms a roof over the spinal canal in the back of the spine. The needle is inserted between adjacent laminae to access the epidural space and administer the medication for the epidural nerve block.
The epidural space contains fats to absorb shock, blood vessels and nerve roots. The epidural nerve block numbs sensation by blocking the transmission of pain signals from the nerves to the brain. An epidural nerve block may be administered in the cervical, thoracic, lumbar or the caudal (lowermost) region of the spinal column.
Why is an epidural nerve block performed?
An epidural nerve block is performed as anesthesia during surgeries or for pain relief (analgesia) for short periods or to treat chronic pain syndromes.
An epidural nerve block may be performed:
- As the sole method of anesthesia
- In combination with spinal anesthesia (anesthetic injected into the subarachnoid space)
- In combination with general anesthesia
Epidural nerve block is performed for anesthesia in the following situations:
- Orthopedic surgery on the lower limbs including ankles, knees, hips and pelvic area
- Vascular surgery (involving blood vessels)
- Amputation of lower limbs
- Caesarean delivery of pregnancy
- Surgery in the lower abdominal area that include:
- Cardiac and other surgeries in the thoracic region
- Lower body surgeries for children
Epidural nerve block for pain relief may be given as a single injection that lasts up to 24 hours or as a continuous infusion through a flexible tube (catheter) inserted into the epidural space.
Epidural nerve block is useful in pain relief in the following situations:
- Prolonged pain relief with a catheter, after a major surgery
- Pain relief during labor
Epidural injections are used for chronic pain management in the following conditions:
- Diseases in the backbone such as:
- Pinched nerves (radiculopathy)
- Arthritis in the facet joints of the spine (facet arthropathy)
- Narrowing of the spinal canal (spinal stenosis)
- Complex regional pain syndrome
- Pelvic pain
Epidural nerve block is not administered in the presence of certain conditions such as:
- Depletion of fluid in the blood vessels (hypovolemia) due to salt or water loss
- Elevated pressure inside the skull (intracranial pressure)
- Infection at the epidural injection site
- Allergy to local anesthetic
Epidural nerve block may be avoided in certain conditions:
What are the benefits of an epidural nerve block?
- Improved pain relief post-surgery
- Less need for opioids
- Lower incidence of pulmonary complications post-surgery
- Reduced gastrointestinal complications post-surgery
- Lower duration of mechanical ventilation
- Lower risk for deep vein thrombosis
- Reduced blood loss
- Lower dosage of medication
- Longer lasting pain relief
- Improved quality of life
- Reduced dependence on opioids
Health Solutions From Our Sponsors
Top What Is an Epidural Nerve Block Related Articles
Braxton Hicks Contractions (False Labor)
Braxton hicks contractions are also known as false labor pains. Though these irregular uterine contractions may occur in the second trimester, they're more likely to occur during the third trimester of pregnancy. Unlike true labor pains, false labor pains are often irregular, may stop when you walk, rest, or change positions, and the contractions do not get closer together or stronger.
Braxton Hicks vs. True Labor: How to Tell the DifferenceSome pregnant women may mistake Braxton Hicks contractions (false labor) for real labor contractions, especially in the first pregnancy. Real labor contractions occur at regular intervals that become progressively shorter; more painful as labor progresses; are described as a tightening, pounding, or stabbing pain. Braxton Hicks contractions do not occur in regular intervals; do not become longer over time; and may disappear for a period of time and then return. Braxton Hicks contractions occur in third trimester of pregnancy, however, sometimes can occur in the second trimester. True labor contractions begin around your due date (unless your baby is preterm, in which you will be in preterm labor). So how can you tell the difference? Here are a few similarities and differences between Braxton Hicks contractions and True or real labor contractions.
Braxton Hicks contractions
Braxton Hicks contractions tend to become more frequent toward the end of pregnancy, and are not as painful as real labor contractions; do not occur in regular intervals; do not become longer over time; and may disappear for a period of time and then return.
Frequently one of the early symptoms and signs of true labor is when the contractions begin to occur less than 10 minutes apart.
Real labor contractions occur at regular intervals that become progressively shorter; more painful as labor progresses; are described as a tightening, pounding, or stabbing pain; may feel similar to menstrual cramps; and sometimes Braxton Hicks contractions can be triggered by dehydration, sexual intercourse, increased activity of the mother or baby, touching of the pregnant woman's abdomen, or a distended bladder.
Natural and home remedies to soothe and provide comfort for Braxton Hicks contractions include relaxation exercises like deep breathing or mental relaxation; change positions or take a walk if you have been active and rest; drink a glass of herbal tea or water; eat; or soak in a warm bath for 30 minutes (or less).
Preterm labor signs and symptomsWhen you have reached 37 weeks, and the contractions are more painful and are increasing in frequency you will have abdominal pain or menstrual-like cramping, an increase in pelvic pressure or back pain, and the contractions are more than four contractions an hour.
Labor Symptoms (Early Signs)Every woman's experience with labor and delivery is unique for each woman, and thus "Normal" labor varies from woman to woman. Some of the common signs and symptoms of normal labor include the "baby dropping," increase urination, back pain, contractions, and diarrhea.
Epidural Steroid InjectionAn epidural steroid injection is a common procedure to treat spinal nerve irritation that causes chronic low back pain and/or leg pain (radicular pain). Disc herniation is also treated with epidural steroid injections. Epidural injections are also used to treat nerve compression in the neck (cervical radiculopathy).The procedure is quick and simple.
How Long Does a Posterior Tibial Nerve Block Last?A posterior tibial nerve block is a procedure for numbing a portion of the foot. An anesthetic injection is administered near the ankle on the inside of the leg, close to the posterior tibial nerve, blocking the transmission of pain signals to the brain.
How Long Does an Epidural Nerve Block Last?An epidural nerve block is a procedure to block pain by injecting anesthetic medication into the epidural space of the spine. The procedure numbs the relevant nerve region thereby blocking the transmission of pain signals from those nerves to the brain. An epidural nerve block may be administered in the cervical, thoracic, lumbar or the caudal (lowermost) region of the spinal column.
Nerve BlocksNerve blocks are used for different pain treatment and management purposes. There are many different types of nerve blocks for specific areas of the body. A plexus or ganglion is a group of nerves that causes pain to a specific area of the body. The pain area is injected with a nerve-numbing substance called a nerve block.
Pregnancy: Multiple Births, Twins, Triplets, and MoreMultiple births occur when a woman bears twins, triplets, or even more babies during pregnancy. More multiples are born today thanks to assisted reproductive technology (ART), including in vitro fertilization using fertility drugs. Women carrying multiples often give birth via C-section.
Stages of PregnancySee pictures on the various stages of pregnancy. See and learn what changes a woman's body goes through and view fetal images of how her baby grows during the 1st, 2nd and 3rd trimesters.
What Is a Sural Nerve Block?A sural nerve block is a procedure for anesthetizing a part of the calf, lower leg, heel and foot. An anesthetic solution is injected adjacent to the Achilles tendon on the outer side of the foot. The anesthetic blocks the transmission of pain signals from injury or surgery in these parts of the lower leg.
What Is an Infraclavicular Nerve Block?An infraclavicular nerve block is a procedure to numb the brachial plexus nerves, which transmit sensation of the arms. An anesthetic injection is administered below the collarbone (clavicle), adjacent to the brachial plexus, to block the transmission of pain signals to the brain.
Why Is an Epidural So Bad?An epidural is a form of regional anesthesia that blocks pain in a particular region of the body. Most epidural side effects are rare and may include soreness, nausea, shivering, drop in blood pressure, ear ringing, difficulty urinating, backache and soreness.