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Epidural Anesthesia

What Is Epidural Anesthesia and How Is It Performed?

Epidural anesthesia is one of the regional anesthesia methods applied to prevent pain sensation in the desired area of the body. It is applied by an anesthesiologist who is experienced in this regard.
The purpose of epidural anesthesia is only to stop the sensation of pain, unlike general anesthesia, which is the loss of all senses. Sensations such as warmth and touch are not affected.

Although epidural anesthesia, which can be safely applied for various surgical procedures involving the lower half of the body as well as normal and cesarean delivery, is similar to spinal anesthesia, the technique of application is quite different. You are asked to round your back in a sitting or lying position. After applying an antiseptic solution to the waist area, it is anesthetized by giving local anesthesia.

Anesthetics applied to the outside of the sac where the spinal cord fluid is located are sent to the body with a thin tube called a catheter, not by direct injection. The plastic catheter is left inside and allows administration of drugs and repeated doses. It is fixed so that it does not slip with the help of plaster. The patient is conscious and can walk after the procedure.

Although epidural anesthesia is an application that can be performed at all levels; at the levels where the spinal cord ends (2nd). Upper levels from the lumbar vertebra) can result in serious spinal cord injuries. Therefore, it should be administered by highly experienced anesthesiologists.

What Are the Negative Side Effects of Epidural Anesthesia?

Although very rarely seen;
It can cause blood pressure to drop uncontrollably. Therefore, blood pressure is often monitored.
Bleeding, bruising or swelling in the area where anesthesia is applied
Back pain
Nausea and difficulty urinating
These effects are very unlikely to occur. Epidural anesthesia can be applied easily and safely, often without any side effects.

In Which Situations Epidural Anesthesia Is Not Applied?

If the patient does not want to apply;
If there is excessive bleeding or shock
Patients using anticoagulant drugs
For those with bleeding disorders
Those with infection in the intervention area
Epidural anesthesia may not be administered to patients who have undergone surgery for herniated disc or other reasons.


What Is Spinoepidural (Combined) Anesthesia and How is it Performed?

The combined method of spinal and epidural anesthesia is called spinoepidural combined anesthesia. While a comfortable surgical environment is created with spinal anesthesia in patients where a rapid onset is desired, medication is given for postoperative pain control through the inserted epidural catheter. This method is often preferred in cesareans.

The effect of spinal anesthesia starts faster than epidural anesthesia. It is applied together with spinal and epidural anesthesia in cases where postoperative pain treatment is desired to continue with rapid onset.

After the epidural space is found, the thin needle is passed through the epidural needle to reach the spinal fluid and a small amount of drug is given to the spinal fluid. The thin spinal needle is removed and the epidural catheter is inserted into the epidural space. Then the epidural needle is removed and the catheter is fixed to the back as it has always been done. The epidural pump slowly injects the drugs. The effect of spinal anesthesia lasts about 90 minutes. As the effect of spinal anesthesia decreases, epidural anesthesia comes into play.

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