The term epidural (from Ancient Greek ἐπί, "on, upon" + dura mater) is a simplified and all-inclusive term often used to refer to techniques such as epidural analgesia and epidural anaesthesia. The epidural route is frequently employed by certain physicians and nurse anaesthetists to administer diagnostic (e.g. radiocontrast agents) and therapeutic (e.g., glucocorticoids) chemical substances, as well as certain analgesic and local anaesthetic agents. Epidural techniques frequently involve injection of drugs through a catheter placed into the epidural space. The injection can result in a loss of sensation—including the sensation of pain—by blocking the transmission of signals through nerve fibers in or near the spinal cord.
Spinal anaesthesia is a technique whereby a local anaesthetic drug is injected into the cerebrospinal fluid. This technique has some similarity to epidural anaesthesia, and lay people often confuse the two techniques. Important differences include:
To achieve epidural analgesia or anaesthesia, a larger dose of drug is typically necessary than with spinal analgesia or anaesthesia.
The onset of analgesia is slower with epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia.
An epidural injection may be performed anywhere along the vertebral column (cervical, thoracic, lumbar, or sacral), while spinal injections are typically performed below the second lumbar vertebral body to avoid piercing and consequently damaging the spinal cord.
It is easier to achieve segmental analgesia or anaesthesia using the epidural route than using the spinal route.
An indwelling catheter is more commonly placed in the setting of epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia.
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