Epidural anaesthesia: Is it painful? When is it used?

Definition of epidural anesthesia

Epidural anaesthesia (PDA) is one of the regional anaesthetics and is used to eliminate the sensation of pain in certain regions of the body. This is used especially if surgery is to be performed in this region of the body. In addition, epidural anesthesia can be used to ensure freedom from pain during the first days after an operation.

The term epidural anaesthesia is derived from the Greek. The words “peri” = “next to, around” and “dura” = “hard” refer to the anatomical area where the drug is supposed to act: This is injected into the space around the hard spinal cord skin using a needle or thin tube. This space is called the epidural space and is located in close proximity to the spinal column. The area in which the pain sensation is eliminated depends on the anatomical puncture site on the back: In order to eliminate pain in the upper abdomen, an injection at the level of the (upper) thoracic spine is necessary, and an injection in the area of the (lower) lumbar spine is necessary for anesthesia of the legs.

How painful is epidural anesthesia?

Epidural or epidural anaesthesia is an injection with a fine needle for local anaesthesia. This is usually the most painful part of the procedure. The local anaesthetic is distributed into the area to be punctured and also into the deeper layers.

After a short time of application and consultation with the patient, the actual puncture is performed to anaesthetize the area to be operated. During this puncture, the patient should “only” feel a feeling of pressure and no more pain. In case of difficult anatomical bony conditions in the area of the spine, several attempts may be necessary to reach the desired area.

However, this is only done under sufficient local anesthesia. If the injection needle touches the bony vertebral bodies during the puncture, a brief pain may occur. The aim is to deliver the anesthetic directly to the area around the spinal nerve roots.

Since these can also be touched briefly by the needle, an “electric sensation” or “tingling sensation” can occur in the area supplied by this root. Short muscle twitches are also possible. This procedure is a very safe standard procedure of anesthesia. Nevertheless, the responsible anaesthetist (anaesthetist) will thoroughly inform each patient about the procedure and possible complications.