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epidural block

INTRODUCTION

Your doctor has discussed an epidural block with you. This brochure provides you with information on an epidural block. For general information about a nerve block, please consult the Nerve Block brochure.

WHAT IS AN EPIDURAL BLOCK?

An epidural block is a treatment where drugs are injected into the epidural space, located in the spinal canal in the space around the spinal cord and nerve roots. During an epidural block, an anti-inflammatory and anesthetic drug is injected into the epidural space to reduce pain. This treatment can take place on the neck, chest, lower back, or tailbone. An epidural block can be useful for the following pain complaints:

  • Pain in the neck, chest, or lower back with or without radiation to the head, arms, or legs;
  • Tailbone pain.

PREPARATION

  • If you are taking anticoagulants (also known as blood thinners) (e.g. Sintrom, Marcoumar or Acenocoumarol, Rivaroxaban, or Dabigatran), you must stop before the treatment. Please consult your Anesthesiologist/Pain Management Specialist to find out how far in advance you should stop.
  • Inform the Anesthesiologist/Pain Management Specialist of allergies or hypersensitivities to X-Ray contrast fluid.
  • The treatment almost always takes place as an Outpatient (Day Care) procedure. Do keep in mind that after the procedure you are NOT allowed to drive home yourself because, after the block, there may be a temporary loss of strength or sensation.
  • You are typically allowed to eat, drink and take your other medication as usual. If you do need to be fasting, the Specialist will discuss this with you in advance.
  • If you are pregnant or think you may be, the treatment cannot take place.
  • The treatment is done under local anesthetic and takes about 15 minutes. After the treatment has been administered, you will be taken to the recovery room for half an hour before you are allowed to go home.
  • If you have a fever on the day of treatment, unfortunately, the treatment cannot proceed as scheduled on that day. Please contact the Outpatient Department using the contact information on the back of this brochure as soon as possible!

PROCEDURE

The procedure can be performed sitting or lying down. This depends on the location of your complaints and the preference of the pain specialist. First, the skin is disinfected and anesthetized. A needle is then inserted through the back into the space around the spinal cord. Sometimes X-rays are used to find the right location. When the needle is in the right location, the drugs are injected. The procedure takes about fifteen minutes and the result of the block can be assessed after a few days to weeks. 

Usually, a check-up with the Anesthesiologist/Pain Management Specialist is arranged four to eight weeks after the procedure.

SIDE EFFECTS

All medical treatments and interventions carry some risk, however, treatment for an epidural block rarely leads to permanent damage. The Anesthesiologist/Pain Management Specialist will also discuss your medical history with you to ensure that there are no other factors that may lead to complications and if there are, how best to perform the procedure safely with minimal risk. 

Side effects that can occur are:

  • Bruising or muscle pain at the injection site. This takes a few days to subside and you can use paracetamol if necessary;
  • A temporary loss of strength or numbness in the arms, legs, or pubic area (depending on where the injection was made) that will disappear within a few hours. This is why it is important that you are accompanied to the hospital and is also the reason that you are not allowed to drive home yourself;
  • Temporary difficulty urinating. If you have not urinated within five hours after the treatment, you should contact your Anesthesiologist/Pain Management Specialist;
  • Patients with diabetes sometimes notice that their blood sugars can fluctuate for several days;
  • Women may experience hot flashes and menstruation may be disrupted for a short time;
  • The oral contraceptive pill is no longer reliable after this treatment until the next menstrual period. You can continue to use the pill with other forms of contraceptives;
  • During the procedure, the spinal cord membrane can be accidentally punctured. This complication can cause headaches that usually go away on their own. If the headache does not go away, please contact us;
  • Very rarely an infection that can lead to meningitis (meningitis) or an abscess in the back. This causes fever, headache and/or back pain, and neurological deficits. If this occurs, you should contact your anesthesiologist/pain management specialist immediately.

ADDITIONAL INFORMATION

If you have any questions or if you would like more information, please contact the Outpatient Department using the information at the back of this brochure.

  • The Policlinic days are Tuesdays and Wednesdays.