Epidural anesthesia

Related: Patient guide to anesthesia 

Epidurals help with pain control after major surgery by delivering local anesthetic (freezing agent) near nerves in your spine through a tiny plastic tube. Epidural catheters are very thin plastic tubes that are left while you recover. It is ok to lie on your back with an epidural. 

Your epidural anesthesia will be performed by an anesthesiologist. Anesthesiologists are specialist doctors who have undergone many years of training to perform these procedures.

Before the procedure

If your anesthesiologist recommends an epidural for pain control after the procedure, you will have the epidural done before you receive general anesthesia.

When the operating room is ready for you, you'll be brought to the operating room and sit on the edge of the operating room bed. All of the people involved in your surgery will have a routine safety briefing discussion. 

Your anesthesiologist may or may not give you some sedation medication before the epidural. Your back will be cleaned with a solution that feels cold and a plastic sheet will be placed on your back to keep it very clean. Your anesthesiologist will put some local anesthetic under your skin that makes you numb. They will then find the epidural space with a needle. This normally takes about five minutes to do. 

It’s ok to lie on your back as you recover with an epidural in. While you have an epidural in, a member of the anesthetic team will see you every day to ensure it is working correctly. We expect you to still be able to move your legs easily with the epidural in. 

• Excellent pain control after major surgery
• Reduced side effects from pain medications such as drowsiness and nausea
• Faster return of bowel function
• Reduced breathing problems after major surgery

You will have an opportunity to ask questions if you have any prior to the procedure. While we have asked you to review this information, your anesthesiologist will review their plan for your care with you on the day of surgery and discuss any risks that are relevant to you. 

Common complications of epidurals

• Nausea and itch with epidural anesthesia are easily managed. 
• Epidural anesthesia is occasionally unsuccessful. Sometimes this happens at the time of starting the epidural, sometimes it happens one or two days later. There are alternative methods which can be used to control your pain if this happens. 
• Headache that might require treatment (Post Dural Puncture Headache) happens to approximately 1 in 100 (1%) people following an epidural. 

Rare complications of epidurals

• Rarely, epidurals can cause bleeding or infection near your spinal cord nerves. This can cause nerve damage. 
• The rate of permanent harm following an epidural anesthetic is between 8 and 17 people in 100 000 (0.008-0.017%)

Very rare complications of epidurals

• The rate of paraplegia or death following an epidural anesthetic is approximately 3 in 100 000 (0.003%)
• Approximately 54, 000 people fit in BC Place Stadium when it is full. If everyone in a full stadium had an epidural anesthetics, one or two people may die or become paraplegic. 
• As another comparison in 2020, there were 5.3 deaths on British Columbian roads for every 100, 000 British Columbian residents (Road Safety BC). 

Quoted risks on this website resource are for the general population.  Your personal risk may differ somewhat from the general population, depending on your medical history and what type of surgery you are having.  All patients will have the chance to discuss their personal risks and benefits related to having an anesthetic and surgery with their care providers prior to their procedure.  

The Anesthesiologist conducting your anesthetic on the day of your surgery will finalize your care plan with you before the procedure starts. This final care plan may differ somewhat from what was discussed in the Pre-Admission Clinic and what is outlined on this website.