Adapted from a leaflet from The Royal College of Anaesthetists and The Association of Anaesthetists of Great Britain and Ireland. (March 2004 edition)
Very rare
permanent disabling nerve damage epidural abscess epidural haematoma (blood clot) cardiac arrest (when the heart stops)
Side effects and complications
All the side effects and complications described can happen without an epidural. Side effects are common, are often minor and are usually easy to treat. Serious complications are fortunately rare.
For major surgery, the risk of lasting nerve damage is probably about the same, with or without an epidural.
The risk of complications should be balanced against the benefits. They should also be compared with other methods of pain relief. Your anaesthetist can help you with this.
Very common or common side effects and complications
- Very common means that 1 in 10 people will be affected.
- Common means that 1 in 100 people will be affected.
Not able to pass urine. The epidural affects the nerves that supply the bladder. A catheter will usually have to be put in to drain it. This is often needed anyway after major surgery to check the kidney function.
With an epidural this will be painless.
The bladder returns to normal when the epidural wears off.
Low blood pressure. The local anaesthetic affects the nerves going to your blood vessels. Blood pressure therefore always drops a little. Fluids and or drugs can be put into your drip to treat this. Low blood pressure is common after surgery, even without an epidural.
Itching. This can be a side effect of morphine like drugs used together with local anaesthetic. It is easily treated with drugs.
Feeling sick and being sick. These can be treated with drugs. They happen less often with an epidural than with most other kinds of pain relief.
Backache. This is common, with or without an epidural. It is often caused by lying on a firm flat operating table.
Not enough pain relief. It may not be possible to place the epidural catheter. The local anaesthetic may not spread enough to cover the whole surgical area. Or, the catheter can fall out. Overall, an epidural usually gives better pain relief. Other methods can be used if the epidural fails.
Headaches. Minor headaches are common after surgery, with or without an epidural. People may get a severe headache after an epidural. This is because the lining of the fluid filled space around the spinal cord has been punctured. The fluid leaks out and causes low pressure in the brain, particularly when you sit up.
It may be necessary to inject a small amount of your blood into your epidural space. This is called an epidural blood patch. The blood clots and plugs the hole in the lining. It almost always works straight away.
For more information please see 'Headache after an epidural or spinal anaesthetic'.
Uncommon complications
- Uncommon means that 1 in 1000 people will be affected.
Slow breathing. Some drugs can cause slow breathing and, or drowsiness that needs to be treated.
Catheter infection. The epidural catheter can get infected and may have to be taken out. Antibiotics may be needed. It is very rare for the infection to spread any further than the area where the catheter was put in.
Rare or very rare complications
- Rare means that 1 in 10,000 will be affected.
- Very rare means that 1 in 100,000 will be affected.
Rare
convulsions (fits) breathing difficulty temporary nerve damage