What are the risks of an epidural?

What are the risks of an epidural?

Samuel Seelig (Anesthesiologist, Los Angeles, California) gives expert video advice on: What are the risks of an epidural?; Can I take additional pain medication while having spinal anesthesia or an epidural?; Does general anesthesia affect breastfeeding? and more...

An epidural is a regional anesthetic whereby a large gauge needle is placed in the epidural space, which is just outside of the spinal canal. When placing the epidural, local anaesthetic is used to limit the amount of pain during the procedure. When placing an epidural, sometimes you have to walk off the bone or the lamina of the vertebrae. The needle can bruise that bone and there can be some post-operative discomfort in the site. Once the epidural is activated and the local anesthetic is placed in the epidural space, it's possible that the vasodilatation from the sympathectomy that the patient receives will cause a drop in the blood pressure. That will have to be treated with fluids. When the blood pressure drops after an epidural, which it rarely does, but it does, the patient may become nauseous and may become dizzy. That has to be treated with vasopressures to bring the blood pressure back to eliminate those symptoms.