for those who knows epidural?

Question

how do they inject it to your spine?

Answer 1

It goes in the epidural space. The epidural space is a part of the human spine inside the spinal canal separated from the spinal cord and its surrounding cerebrospinal fluid by the dura mater.

look here http://en.wikipedia.org/wiki/Epidural

Answer 2

Hi! They put a needle into your back and inject the medicine through a catheter placed inside the needle. It really doesn't hurt because they numb the spot before they insert the needle, but you do have to hold still while they give you the epidural. Once the little thin tube is in place , they remove the needle and tape that tube down. I think this is if they need to administer more but not positive. An anesthesiologist will be the one who gives you an epidural, so if you want one be sure to ask for him the minute you hit the hospital doors as it can sometimes take them a bit to get up to your delivery room. Also, he can answer any questions you might have.

The Epidural might slow down your labor, but I have to say that I had one child with one that was administered as soon as I started labor and the second child where it didn't work because I was already dilated to 8. Trust me that the child I had with the epidural was a MUCH more pleasant experience.

This is a very personal decision. There can be complications from the epidural, although they are rare. Also, you might have a hard time pushing if given too much. Side effects (again, very rare) can include headaches, or longer term numbness lasting up to three months.

Good luck with your baby. Hope everything goes well.

Answer 3

An epidural anaesthetic blocks the nerve roots that lead to the uterus and lower part of the body.

These roots are located in a space near the spinal cord called the epidural space. This lies within the spine just outside the outer covering of the spinal cord.

How is an epidural given? An epidural anaesthetic is always given by an anaesthetist. The anaesthetist locates the epidural space by inserting a thin hollow needle - usually into the lower part of the spine.

A small plastic tube is then introduced into the back through the needle and left in position when the needle is removed. This tube is usually connected to an automatic pump, which is adjusted to introduce a certain amount of local anaesthetic and painkilling medication into the epidural space every hour.

Epidural anaesthesia has been used for many years, and is a safe and reliable technique.

It is commonly used in childbirth to alleviate labour pains. In childbirth, epidural anaesthetic is usually started during labour and given before the neck of the womb has started to dilate. It is fully effective in around 96 per cent of cases.

Answer 4

The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of pain signals through nerves in or near the spinal cord.

The epidural space (sometimes called the extradural space or peridural space) is a part of the human spine inside the spinal canal separated from the spinal cord and its surrounding cerebrospinal fluid by the dura mater.

Technique

Using a strict aseptic technique a small volume of local anaesthetic, such as 1% lignocaine (lidocaine in the U.S.), is injected into the skin and interspinous ligament. A 16, 17, or 18 gauge Tuohy needle is then inserted into the interspinous ligament and a "loss of resistance to injection" technique is used to identify the epidural space. This technique works because the interspinous ligament is extremely dense, and injection into it is almost impossible. The anaesthetist advances the Tuohy needle slowly, attempting to inject through it every millimetre or so. Typically a "pop" is felt as the ligamentum flavum is breached. The epidural space contains only loose tissue and veins, which means that injection into it is very easy. The sensation of the "pop" followed by ease of injection is a strong indicator that the tip of the needle is in the epidural space.

Traditionally anaesthetists have used either air or saline for identifying the epidural space, depending on personal preference. However, evidence is accumulating that saline may result in more rapid and satisfactory quality of analgesia[1].

After placement of the tip of the Tuohy needle into the epidural space the catheter is threaded through the needle. The needle is then removed. Generally the catheter is then withdrawn slightly so that 4-6 cm remains in the epidural space. The catheter is a fine plastic tube, down which anaesthetics may be given into the epidural space.

Most commonly, the anaesthetist conducting an epidural places the catheter in the mid-lumbar, or lower back region of the spine, although occasionally a catheter is placed in the thoracic (chest) or cervical (neck) region. In adults, the spinal cord terminates at the first lumbar vertebra, below which lies a bundle of nerves known as the cauda equina ("horse's tail"). Hence lumbar epidurals carry a very low risk of injuring the spinal cord.

A common solution for epidural infusion in childbirth or for post-operative analgesia is 0.2 percent ropivicaine and 2 μg/mL of fentanyl. This solution is infused at a rate between 4 and 14 mL/hour, following a loading dose to initiate the nerve block.

Typically, the effects of the epidural are noted below a specific level on the body (dermatome). This level (the "block height") is chosen by the anaesthetist. The level is usually 3-4 dermatomes higher than the point of insertion. A very high insertion level may result in sparing of very low dermatomes. For example, a thoracic epidural may be performed for upper abdominal surgery, but may not have any effect on the perineum. However, giving very large volumes into the epidural space may spread the block both higher and lower.

In some unusual instances, it may not be required to insert a catheter into the epidural space, e.g. for steroid injections; see below. The anesthesiologist may inject medication into the epidural space through the needle, then remove the needle.

Answer 5

I guess the best way to explain it to someone with out all of the medical mumbo jumbo lolol is. they give you a local shot to numb the area, they insert the needle and they go into the spinal fluid. this area is right before the area that your nerves are incased in. Look at it this way there are two tubes running down your spine, one inside the other. The smaller one that is in the center is where the nerves are held. The outer large one holds the fluid. So the place the epidural needle into the outer tube. The remove the needle and leave a small tube in there so they can inject the medicines that will numb you......Very similar on how they use a needle to start your IV and then remove the needle and leave the IV in place. Hope this helps

Answer 6

OK, first they give you a local anesthetic where they will be inserting the epidural needle. Once that is numb, they use a large needle and insert it between the vertebra into the epidural space in your spine. Once they have that in place, they insert a catheter through it into that space. That's when they will give a loading dose of the numbing meds. They remove the needle and tape down the catheter. It is a long catheter, they bring it up and over your shoulder and hook it up to a pump that will give you so much meds in a certain amount of time. The most painful part is when they give you the local. It stings a little. The rest feels like pressure.

Answer 7

For my last delivery, I had an epidural as a last resort, I had to sit on the side of the bed with my back curved out, I found leaning against my husband the easiest, they gave me a local injection around the actual injection site, and then inserted the needle which would feed the actual anesthetic into my back, the needle itself is a normal needle surrounded by a plastic sleeve, when they insert the needle they remove the actual needle and leave the plastic sleeve behind which they then tape in place. They will connect a tube to it which will be taped to your shoulder, this will be the actual site of the anesthetic being injected.
When it is injected it doesn't hurt but feels like they are running an ice cube down your back, the relief is pretty much instant, but I did find that it wore off unusually, it wasn't a gradual wearing off though that's what it seemed like to start with, like you can just start feeling things again and then whammo, its gone and the pain is back, so just be sure to tell the docs as soon as you start feeling anything again. Its also not uncommon for your blood pressure to drop rapidly when you have this kind of pain relief, this happened to me and I blacked out for just a minute, which was kind of scary because no one pre warned me that it could happen...

Over all I rate this kind of pain relief right up there with chocolate and cookies...its wonderful!!

Answer 8

I've had an epidural twice. An epidural is not given until you are in active labor. Before the procedure begins, IV fluids are started. You will be asked to position yourself on your left side or in a sitting position with your chin on your chest and you knees close to your abdomen. This position is uncomfortable for most women, however, I’ve had both done and sitting was the better position for me. The waistline area of your mid back is wiped with an antiseptic solution to reduce the skin bacteria and lessen the chance of infection. A coin-sized area of skin is numbed with an injectable local anesthetic. Then a larger needle is placed through the numbed area and into the epidural space of your spine.

A small tube, called a catheter, is threaded into the first needle until the tip of the catheter reaches the epidural space. The needle is carefully removed leaving the catheter in place so more medicine can easily be injected later. A "test dose" of medicine is injected into the catheter to confirm proper placement. The catheter is taped to your back. Once in place the catheter does not restrict moving from side to side in bed and it is not felt in the back. The pain felt during placement of the catheter may be a slight pinch or it may be painful for several minutes.

3-5 minutes following the initial dose, the nerves of the uterus begin to numb. After 10 minutes you will feel the full numbing effect. As the initial dose of anesthetic begins to wear off, another dose can be given through the catheter before contractions become too uncomfortable. Additional doses will be given every one to two hours depending on the type of medicine and the amount and strength of each dose.

Once your baby is born, the catheter is removed. The effects of the anesthesia usually wear off completely in one or two hours. After the medicine wears off, you may feel an uncomfortable burning feeling around the birth canal, but I didn’t. Having the epidural was the greatest thing. I still felt my contractions and knew when to push, but they were painless. It allowed me to enjoy my birthing experience. Hope that helps!

Answer 9

They inject into your spinal column, in your lumbar area. They inject below your spinal cord between the 4th and 5th lumbar vertebrae. They first numb up the skin with a local anesthetic. Then they insert a long needle into the spinal column. The doctor will feel a slight pop, which tells him he is in the right place, they first inject saline to test to make sure they are in the right place, it will go in easy if it is, if not then they try again. Then they inject with the local anesthetic. They replace the needle with a tubing that is taped up your back which is connected to a machine that delivers a constant flow of anesthetic until the nurse switches it off for delivery. Sounds scary, but not painful and soooo Worth the pain relief!!!!

Answer 10

1st they sanitize your back, numb you with a local anesthetic, then insert the needle in the epidural space surrounding the spine, then they insert the catheter and pull the needle out. Last they tape everything in place. Then they will ask you questions like can you wiggle your toes, do you have a metallic taste in your mouth, to make sure its inserted right.