What is epidural anesthesia?

This type of anesthesia has become widely known due to its use in obstetrics and gynecology, as it is widely used to facilitate labor.

In this area, epidural anesthesia has become a popular and comfortable method of pain relief. However, like any other method of anesthesia, it requires compliance with certain indications and contraindications.

Epidural anesthesia, along with spinal anesthesia (they are similar in their mechanism of action), is one of the methods of regional anesthesia.

We will explain the mechanism of action of regional anesthesia using a more understandable example, known to almost everyone.

Remember the feeling in the dentist’s chair when, after local anesthesia, the cheek becomes “big”, “strange”, clumsy, and practically does not feel anything.

This is due to the fact that the dentist injects a special drug (local anesthetic) into the area where the nerve passes and this nerve stops working as it should. In other words, in the area of action of the nerve, neuromuscular transmission is temporarily disrupted, which is why such strange sensations are caused. And where the nerve is blocked, there is a feeling of immobility and anesthesia, which allows the necessary manipulations to be carried out.

The same mechanism of action underlies epidural/spinal anesthesia, only the technique of administering the anesthetic drug (local anesthetic) is different and the area of pain relief is wider in the literal sense of the word.

What are the differences between spinal and epidural anesthesia

With epidural/spinal anesthesia, pain medication is injected between the vertebrae into the so-called epidural or spinal space, which gives these methods of pain relief their name.

What are the differences between the two most popular methods:

• Epidural anesthesia is a type of pain relief in which a drug is injected into the epidural space, located above the dura mater of the spinal cord, thereby blocking sensation and motor activity in a certain area of the body. Depending on the injection site (spinal region), the type of drug, and its concentration, it is possible to anesthetize various areas of the body and achieve varying degrees of severity of anesthesia effects. Also, with epidural anesthesia, it is possible to install a catheter in the epidural space, through which long-term postoperative pain relief can be provided.
• Spinal anesthesia, in turn, is anesthesia through a single injection of an anesthetic drug into the cerebrospinal fluid through a puncture of the dura mater. This method is a single injection at the level of the lumbar spine (where the spinal cord ends, don’t be afraid the spinal cord is not affected!), providing pain relief and immobilization of the lower part of the body (below the navel) for several hours.

These analgesic techniques can be combined with general anesthesia to provide patient and surgeon comfort during surgery.

Why epidural anesthesia is used in oncology surgery

Some types of surgery are performed only under general anesthesia (anesthesia).

However, experts are inclined to believe that the use of epidural anesthesia or spinal anesthesia in combination with general anesthesia is more preferable, because it can significantly improve pain control, surgical stress during surgery, and afterwards also speed up recovery by improving tissue microcirculation in areas of anesthesia.

Epidural anesthesia is widely used during operations on the abdominal organs, pelvis, and lower extremities, both alone and in combination with general anesthesia.

Anesthesia as a way to relieve pain in cancer patients

Already in the early stages of the pathological process, pain occurs in 35-50% of patients. As the disease progresses, the severity of the syndrome increases to 80%, while the nature of the pain differentiates from moderate to severe. In the terminal stage, pain is felt by 95% of patients in the oncology department. In this regard, the need for the use of painkillers that can improve the patient’s quality of life is obvious.

The choice of the optimal method of anesthesia depends on the stage of development of the disease, state of health and the presence of concomitant diseases, as well as the severity of pain and other characteristics. The development of a pain relief regimen for such patients is the result of the work of a team of doctors. In the initial stages, medications are prescribed that can be taken orally, but as the disease progresses, many of them no longer work properly. Pain-relieving patches often do not help either. In this case, specialists resort to interventional techniques; epidural anesthesia is one of the options for pain relief in such cases.

Consultation and diagnostics of specialists when choosing the optimal method of anesthesia

The choice of the appropriate method of pain relief for any surgical intervention is individual.

The patient's expectations, his pain threshold, all the characteristics of the body, the type of operation, its duration and goals, and the objectives of postoperative rehabilitation are taken into account.

Together with the patient, a pain management plan is developed throughout the entire perioperative period (before, during, after surgery).

The correct choice of anesthesia is one of the steps towards noticeable results and easier recovery.

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