Patient advice following epidural analgesia

Serious complications from epidural analgesia are rare. In extremely rare cases (up to 1 in 10,000 patients) nerve damage may occur. This can happen during the procedure. Nerve damage may be caused by infection or haematoma (blood clot), which can occur up to 2 weeks after an epidural. In the unlikely event that this happens it is important to diagnose and treat it as quickly as possible.

This leaflet tells you what to look for and what action to take if you think that you have a problem.

When will I be assessed? Who will assess me?

At the end of treatment with epidural analgesia, the doctors and nurses caring for you will assess you. They will make sure that you do not have any left over numbness or weakness in your legs from the drugs. They will ask you to move your legs and check the sensation in your legs. They need to make sure that this is the same as it was before your operation.

It is important to remember that some operations can cause altered sensation in the legs. Any changes may be as a result of the surgery and not the epidural. When the team remove the epidural, if you do have altered sensations they can discuss this with you.

What signs and symptoms should I look out for?

• Numbness and / or weakness in your legs. Not able to put your weight on your legs (weight bear).

• Redness, pus, tenderness, or pain where the epidural catheter was inserted.

• High temperature, neck stiffness.

• Difficulty passing water (urine) / incontinence of faeces (poo).

What should I do if I have any of these symptoms whilst still in hospital?

If you have any of these signs and symptoms and you have not had them before, tell the nurse-in-charge of the ward. They should to contact the on-call anaesthetist immediately.

What should I do if I have any of these symptoms once I get home?

If you have any of these symptoms after you go home, go to your nearest Emergency Department immediately. The on-call anaesthetist will need to assess you.

Useful information

• Royal College of Anaesthetists. Epidural anaesthesia relief during and after surgery. 6th Edition, June 2023.

• Royal College of Anaesthetists. Section 10: Headache after a spinal or epidural injection. Revised edition 2015.

References

• Discharge advice for patients as used by Wrexham Maelor Hospital from the National Audit of Major Complications of Central Neuraxial Block in the United Kingdom, Report and Findings, 3rd National Audit Project, Royal College of Anaesthetists, January 2009.