An epidural anaesthetic is a locally acting drug injected into the spine to numb the lower part of the body completely. If you are having an operation such as a knee replacement, your consultant may advise an epidural.  

What to expect on the day of surgery

You will need to have the same general pre-operative checks as if you were going to have a general anaesthetic. These will include:

  • Checking your medical history for problems such as asthma, allergic reactions to any drugs, and asking you about current medication for any related or unrelated medical problems.
  • Checking your blood pressure and listening to your heart.
  • Asking you about smoking: if you smoke, all our consultants will strongly recommend that you stop for as long as possible before your operation and resist smoking again for as long as possible afterwards. Smoking reduces your body’s ability to heal wounds, and stopping smoking can make your recovery easier.
  • Finding out about any dental issues: loose teeth, crowns or bridges can be dangerous if they come out while you are being intubated under anaesthetic.
  • Reminding you about your personal items: you will also need to arrive for surgery without your hearing aid, contact lenses or glasses.

You will be prepared for theatre and will be fitted with compression stockings to prevent deep vein thrombosis, and then you will placed in the correct position for the epidural to be administered into your back. 

The anaesthetist will introduce a needle into the space around your spinal cord that contains spinal fluid and insert the epidural anaesthetic. You may have a local anaesthetic just before to numb the skin. 

The epidural anaesthetic blocks signals from the nerves from the lower part of the body into the spine, your legs and lower abdominal area will become completely numb and you will not be able to move your legs until the anaesthetic wears off. 

For a short operation, a single epidural injection is usually all that you need but for longer operations we use a pump to infuse anaesthetic into your back for as long as the surgeon requires. 

What if I feel anxious? 

Some patients may feel anxious and distressed about being awake for surgery and we can give you a sedative to help you feel more relaxed and calm.  We also take care to screen off the surgical work from your view but you will be aware of the surgical team. Our surgeons and nurses will talk to you throughout the procedure to reassure you. 

Recovering after an epidural anaesthetic 

Most patients do not feel drowsy after an epidural but they cannot move when they get back to their room until the anaesthetic wears off.  You will feel no pain at first, but then pain relief can be given to control any discomfort.  Some patients find that they cannot pass urine until the epidural wears off because it blocks sensation to the bladder. You will have a catheter for a few hours to help you urinate, but this is usually removed early the next day.