Epidural Headache With A Late Onset Story





What Is An Epidural?



An epidural is a procedure whereby drugs are injected through a catheter which is inserted into the epidural space.  The epidural space is the space between the bony spinal canal and the dura (which surrounds the spinal cord and spinal fluid).  An epidural is a form of regional anesthesia, it causes reduction in sensation and pain as it blocks nerve signals in or near the spinal cord from being transmitted. The procedure is generally only as painful as having blood taken. A small drip is placed in the epidural space to which local anesthetic can be injected as required. The strength of pain relief can be varied so that it blocks the pain of labor pains or increased if surgery is needed. Excellent pain relief can be obtained for days if needed after some surgeries by injecting anesthesia into the epidural drip and this is a major advantage for epidurals in certain operations.

What Is Spinal Anesthesia?

Spinal anesthesia is slightly different to an epidural in that a smaller needle is used to inject a local anesthetic drug into the spinal fluid. Spinal anesthesia is often used for emergency cesarians as the result is immediate pain relief and loss of sensation. A spinal anesthesia is more likely to cause an epidural headache as the dura is punctured during the procedure which can cause spinal fluid to leak. The needle used however is very fine so the hole in the dura should be smaller and seal quicker than if an epidural needle which is a larger needle accidently penetrated it.  If leaking spinal fluid is caused by either procedure and the dura does not seal itself naturally within 48 hours and causes severe headache (worse on sitting and standing and better laying down), a blood patch should be performed by the anethesist.

A major advantage of an epidural or spinal anesthesia during childbirth is that if a mother requires a cesarean, it allows her to remain awake for the birth of her child which is not an option during general anesthesia. 



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