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All about your epidural block

What is an epidural block?

An epidural block is an injection of medication, usually a local anesthetic and a steroid, into the epidural space for the purposes of pain relief and reduction of inflammation. The epidural space is the area around your spinal cord. Medication injected there acts upon the nerves which connect to the spinal cord, transmitting pain signals from other parts of your body.

Where will the medicine be injected?

The medicine is injected between the vertebrae (back bones) in the area where the affected nerves connect. An epidural block may be performed in any area of the spine. Cervical epidural is performed in the neck area. Thoracic epidural is performed in the area between the shoulder blades. Lumbar epidural is performed in the low back region. Caudal epidural is performed in the tailbone area. The type of epidural depends on the type of pain experienced and the location.

Is the procedure painful?

Most people describe the procedure as slightly uncomfortable. The area is numbed before the procedure which diminishes the "sticking" sensation of the injection. Some pressure or cramping may be expected, and occasionally a shock-like sensation is felt. People who have had two or more back surgeries in the area may experience more discomfort due to the presence of scar tissue. You will be fully awake during the procedure; however, some physicians will give sedation before the procedure, if needed.

How long will it take?

You can expect to be in the clinic for about 1½ hours. When you arrive, the nurse will briefly review some information with you, provide you with a gown to change into, place an intravenous catheter in your vein, and attach monitors to watch your heart rate, blood pressure and oxygen levels. You may be taken to a treatment room with x-ray equipment and placed on your abdomen for the block. The procedure takes only five to 15 minutes. Then you will be taken to a recovery area for monitoring and discharge teaching. You may have some extremity numbness for a short while after the procedure. You will be discharged when you are stable, able to urinate and able to walk unassisted, usually within an hour after the procedure.

Are there any restrictions afterward?

You will not be permitted to drive yourself home, because the medicines used can cause drowsiness, slow response and reduced coordination. Therefore, you must make arrangements for someone to take you home. Otherwise, you are free to eat, drink or move normally, although we recommend you take it easy the rest of the day. You should avoid heavy lifting or excessive bending, twisting, pushing, pulling, etc., until all of your blocks are completed.
For more information about epidural blocks, call Baptist Health Louisville's Center for Pain Management at (502) 896-7246.