epiduraalse

Epidural anesthesia is a regional anesthesia technique in which local anesthetic, with or without an opioid, is injected into the epidural space—the potential space between the dura mater and the surrounding vertebral walls. In some languages, the adjective describing this technique, such as epiduraalse, is used to modify nouns relating to the epidural space or its procedures.

Administration commonly occurs in the lumbar region (for example at the L3–L4 or L2–L3 interspaces). A needle is advanced until the epidural space is identified, and a catheter may be threaded to allow repeated dosing or continuous infusion.

Uses and benefits: In obstetrics, epidural analgesia provides extensive pain relief during labor while preserving consciousness. It is also used for anesthesia in abdominal, pelvic, lumbar, and lower extremity surgery, and for postoperative or cancer-related chronic pain relief through continuous epidural infusion or patient-controlled analgesia.

Pharmacology: Local anesthetics such as bupivacaine, ropivacaine, or lidocaine are typical, sometimes combined with neuraxial opioids (e.g., fentanyl or morphine) to enhance analgesia.

Risks and contraindications: Complications can include hypotension from sympathetic blockade, accidental dural puncture with post-dural puncture headache, infection, epidural hematoma, nerve injury, catheter misplacement, and systemic local anesthetic toxicity. Contraindications include patient refusal, bleeding disorders, infection at the injection site, or severe hypovolemia.

History: The epidural technique was developed in the 20th century and has become a standard option for perioperative and obstetric analgesia.