Epidural anesthesia blocks pain in a specific region of the body by blocking nerve impulses from the lower spinal segments, resulting in decreased sensation in the lower half of the body. It provides pain relief rather than total lack of feeling. There are different types of epidurals depending on the location of administration, including cervical, thoracic, lumbar, and caudal epidurals, which are used for operations below the diaphragm and in certain patient populations or conditions.

1. Epidural anesthesia is are regional anesthesia
that blocks pain in particular region of the
body .
The goal of an epidural is to provide analgesia ,
or pain relief , rather than anesthesia ,which
leads to total lack of feeling . Epidural blocks
the nerve impulses from the lower spinal
segments. This results in decreased sensation
in the lower half of the body.

2. 1-CERVICAL EPIDURAL
2- THORACIC EPIDURAL
3- LUMBAR EPIDURAL
4-CAUDAL EPIDURAL

3.  All Operation below diaphragm
 May be used in –
1- poor risk patient
2- cardiac disease
3- pulmonary diseases
4- metabolic disturbances
5- when spinal anesthesia is contraindicated
6- painful conditions including post op
condition

4.  SEVERE HEMORRHAGE
 COAGULATION DEFECT
 PREVIOUS LEMINECTOMY
 UNCOOPERATIVE
 LOCAL INFALMMATION AT SITE
 PATIENT REFUSAL

5.  WELL DEFINED AREA OF ANESTHESIA
 LONGER DURATION
 MORE SEVERE DISTURBANCES OF SPINAL
ANESTHESIA MINIMIZED
 GI COMPLAINS MINIMIZED
 CATHETERIZATION MINIMIZED
 LESS RESPIRATORY EFFECTS

6.  TECHNICALLY MORE DIFFICULT
 MUSCLE RELXATION NOT COMPLETE
 LARGE VOLUME NECESSARY
 DANGER OF DURAL PUNCTURE
 PATCHY BLOCK

7.  HEIGHT OF PATIENT
 DRUGS USED
 VOLUME
 CONCENTRATION
 LEVEL OF PUNCURE AND CATHETER
INSERTION

8. - METHOD-
1-SINGLE DOSE INJECTION
2- FRATIONAL –CONTINOUS EPIDURAL –
REPEATED INJECTIONS OF LA THOUGH
CATHETER INSERTED INTO EPIDURAL SPACE

9.  CERVIC AL EPIDURAL –SITTING (C7)
 THORACIC EPIDURAL (T7)
 LUMBAR EPIDU LATERAL(L1-L2,L2-L3,L3-
L4,L4-L5)
LATERAL DECUBITUS ,FULL FLEXION

10.  25 GAUZE NEEDLE FOR SKIN ANALGESIA .
 4 CM ,22 GAUZE NEEDLE FOR DEEP
INFILTRATION .
 18 GAUZE FOR EPIDURAL
 EPIDURAL CATHETER
 NORMAL SALINE
 INJECTION DRUGS
 SYRINGES

11.  HAND WASH
 WEAR GLOVES
 THE SKIN OVER THE INJECTION SITE IS
MARKED AND CLEANED WITH BETADINE
 A FLUOROSCOPIC X-RAY IS USED TO LOCATE
THE CORRECT VERTEBRAL LEVEL FOR NEEDLE
 A LOCAL ANESTHESIA IS INJECTED INTO
THEVSKIN AND UNDERLYING TISSUES TO
NUMB THE AREA

12.  AN EPIDURAL SPINAL NEEDLE IS INSERTED
INTO THE INTENDED INJECTION SITE AND
GUIDED USING FLUOROSCOPY
 A CONTRAST DYE IS INJECTED INTO THE
EPIDURAL SPACE TO CHECK THE SPREAD OF
THE INJECTED CONTENTS
 ONCE THE SPREAD IS CONFIRMED , THE
STEROID MEDICATION IS INJECTED INTO THE
EPIDURAL SPACE

13. A TINGLING OR MID BURNING SENSATION OR
THE FEELING OF PRESSURE MAY BE
EXPERIENCED AS THE MEDICATION ENTERS
THE EPIDURAL SPACE WHEN THE IJECTION IS
COMPLETED , THE IRRITATION AND
DISCOMFORT USUALLY DISAPPEAR WITHIN A
FEW MINUTES . THE PATIENR IS USUALLY
MONITORED IN A RECOVERY ROOM FOR 30
MINUTE TO AN HOUR WHERE VITAL SIGNS
ARE CONTINUOUSLY MONITORED

14. DRIVING AND STRENUOUS PHYSICAL ACTIVIES
AND FLYING IN AN AIRPLANE ARE NOT
RECOMMENDED ON THE SAME DAY AFTER
THE PROCEDURE.