Editing Epidural administration (section)

{{Short description|Medication injected into the epidural space of the spine}}
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{{Redirect|Epidural|the anatomical site|Epidural space|other uses|Epidural (disambiguation)}}
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{{Infobox medical intervention
| Name        = Epidural administration
| Image       = Epidural.JPG
| alt         = 
| Caption     = A freshly inserted [[lumbar]] epidural [[catheter]]. The site has been prepared with [[tincture of iodine]], and the [[dressing (medical)|dressing]] has not yet been applied. Depth markings may be seen along the shaft of the catheter.
| ICD10       =
| ICD9        = {{ICD9proc|03.90}}
| ICD9_mult   =
| MeshID      = D000767
| OPS301      = {{OPS301|8-910}}
| MedlinePlus = 
| OtherCodes  =
}}

'''Epidural administration''' (from [[Ancient Greek]] ἐπί, "upon" + ''[[dura mater]]'')<ref name="OED">{{cite OED |term=Epidural |access-date=1 November 2020}}</ref> is a [[route of administration|method of medication administration]] in which a medicine is injected into the [[epidural space]] around the [[spinal cord]]. The epidural route is used by physicians and [[nurse anesthetists]] to administer [[local anesthetic]] agents, [[analgesic]]s, [[Laboratory diagnosis of bacteria|diagnostic]] medicines such as [[radiocontrast agent]]s, and other medicines such as [[glucocorticoid]]s. Epidural administration involves the placement of a [[catheter]] into the epidural space, which may remain in place for the duration of the treatment. The technique of intentional epidural administration of medication was first described in 1921 by the Spanish [[Aragonese people|Aragonese]] military surgeon [[Fidel Pagés]].

Epidural anaesthesia causes a loss of [[Somatosensory system|sensation]], including [[pain]], by blocking the transmission of signals through [[nerve fibres]] in or near the spinal cord. For this reason, epidurals are commonly used for [[pain control]] during [[childbirth]] and [[surgery]], for which the technique is considered safe and effective, and is considered more effective and safer than giving pain medication by mouth or through an [[intravenous line]]. An epidural injection may also be used to administer [[steroids]] for the treatment of [[Inflammation|inflammatory]] conditions of the spinal cord. It is not recommended for people with severe bleeding disorders, low platelet counts, or infections near the intended injection site. Severe complications from epidural administration are rare, but can include problems resulting from improper administration, as well as [[adverse effect]]s from medicine. The most common complications of epidural injections include bleeding problems, [[headache]]s, and inadequate pain control. Epidural analgesia during childbirth may also impact the mother's ability to move during labor. Very large doses of anesthetics or analgesics may result in [[respiratory depression]].

An epidural injection may be administered at any point of the spine, but most commonly the [[lumbar spine]], below the end of the spinal cord. The specific administration site determines the specific [[nerve]]s affected, and thus the area of the body from which pain will be blocked. Insertion of an epidural catheter consists of threading a needle between bones and ligaments to reach the epidural space without going so far as to puncture the ''dura mater''. Saline or air may be used to confirm placement in the epidural space. Alternatively, direct imaging of the injection area may be performed with a [[portable ultrasound]] or [[fluoroscopy]] to confirm correct placement. Once placed, medication may be administered in one or more single doses, or may be continually infused over a period of time. When placed properly, an epidural catheter may remain inserted for several days, but is usually removed when it is possible to use less invasive administration methods (such as oral medication).