epidural anesthesia/analgesia, a type of anesthesia block in which a local anesthetic is injected into the epidural space surrounding the dural sac, which contains CSF and the spinal cord. Epidurals are most commonly performed in the lumbar area by an injection of medication through a catheter placed in the epidural space. Analgesia is maintained by either intermittent dosing or a continuous infusion into the catheter. Close monitoring of vital signs, respirations, pain, and sensation is important. Epidurals have a wide application in anesthesia and pain management because of their safety and versatility. Epidural anesthesia or analgesia can be tailored to affect an area of the body from the lower extremities to the upper abdomen (thoracic epidural). Epidurals are often used for labor and birth and in postoperative pain management. The most common adverse effects include unintentional dural membrane puncture, postdural puncture headache, and hypotension from sympathetic nerve block and vascular dilation. Severe complications may include intravascular injection of local anesthetic, seizures, or hematoma of the epidural space. See also caudal anesthesia, epidural hematoma, regional anesthesia.
