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A spinal anaesthetic delivers drug to the subarachnoid space and into the cerebrospinal fluid (CSF), allowing it to act on the spinal cord directly. An epidural delivers drugs outside the dura (outside CSF), and has its main effect on nerve roots leaving the dura at the level of the epidural, rather than on the spinal cord itself.
Epidural steroid injection (ESI) is a technique in which corticosteroids and a local anesthetic are injected into the epidural space around the spinal cord in an effort to improve spinal stenosis, spinal disc herniation, or both. It is of benefit with a rare rate of major side effects.
Medical intervention Epidural administration A freshly inserted lumbar epidural catheter. The site has been prepared with tincture of iodine, and the dressing has not yet been applied. Depth markings may be seen along the shaft of the catheter. ICD-9-CM 03.90 MeSH D000767 OPS-301 code 8-910 [edit on Wikidata] Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method ...
Rare side effects include subdural or spinal bleeding, infection, and seizure, [9] though EBPs do not carry a significant infectious risk even in immunocompromised people. [14] Neurological symptoms occasionally develop as a result of administration. [4] Seven cases of arachnoiditis have been documented. [10]
Post-dural-puncture headache (PDPH) is a complication of puncture of the dura mater (one of the membranes around the brain and spinal cord). [3] The headache is severe and described as "searing and spreading like hot metal", involving the back and front of the head and spreading to the neck and shoulders, sometimes involving neck stiffness.
Spinal and epidural are the most commonly used forms of central neuraxial blockade. Spinal anesthesia is a "one-shot" injection that provides rapid onset and profound sensory anesthesia with lower doses of anesthetic, and is usually associated with neuromuscular blockade (loss of muscle control).
Possible side effects include sleepiness, muscle twitching, ringing in the ears, changes in vision, low blood pressure, and an irregular heart rate. [5] Concerns exist that injecting it into a joint can cause problems with the cartilage. [5] Concentrated bupivacaine is not recommended for epidural freezing. [5]
An epidural abscess refers to a collection of pus and infectious material located in the epidural space superficial to the dura mater which surrounds the central nervous system. Due to its location adjacent to brain or spinal cord, epidural abscesses have the potential to cause weakness, pain, and paralysis.
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