How is an epidural anaesthetic performed?

An intravenous 'drip' will be started. The epidural injection may be performed with you lying on your side or sitting up. You will be asked to 'round' your back by drawing up your knees and flexing your neck. The skin is anaesthetised and thereafter the epidural injection should be relatively painless. It is important that you stay as still as possible while this injection is in progress. This will take a few minutes.

A catheter (fine plastic tube) will be inserted through the epidural needle into the epidural space. The needle is then withdrawn and the catheter is taped in place. Injections of pain-relieving drugs will then be introduced through it. The epidural drugs may take up to twenty minutes to take full effect. You may then notice numbness and a sensation of heaviness or weakness in the legs. Although your labour contractions will continue, they should not be painful. The epidural anaesthetic reduces the urge to urinate and sometimes insertion of a urinary catheter may be necessary.

Each dose of the epidural injection will last from two to four hours, depending on your response and the type and amount of local anaesthetic injected. An infusion of local anaesthetic may be started to give you continuous pain relief during labour. If, however, you begin to feel contractions, ask the midwife for a 'top-up'. This is given through the epidural catheter and should keep your pain under control.

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