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Epidural and Nerve Block Patient Information Sheet
Department of Anesthesiology, St Joseph Hospital
Lexington, Kentucky
Regional Anesthesia (nerve block) refers to using local anesthetics (numbing
medicine) to temporarily stop nerves from carrying pain information to the brain.
Regional Anesthesia is divided into two types:
Peripheral Nerve Block – injection of numbing medicine near nerves (outside
of the spine), such as numbing of the arm, leg, or foot
Central or Neuraxial Block– injection of numbing medicine in the back, such
as an epidural or spinal
Regional Anesthesia can be used with a General Anesthetic (going to sleep) or it can be
used as the only anesthesia given. If you don’t go to sleep, we often give IV sedating
medicines during surgery to help you feel comfortable and relaxed.
Epidurals and other Nerve Blocks may be performed primarily to help with aftersurgery pain.
Alternatives or Choices:
Traditional or more common methods of pain control include narcotic pain medicine like
morphine given either by pill or shot (intravenously or in a muscle). Intravenous
methods include PCA pumps where you push a button when you hurt and a computer
delivers a set amount of pain medicine into your IV.
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Reasons an Epidural or Nerve Block may not be offered include:
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Infected skin where the needle will be placed
Signs or symptoms of a serious infection, including fever
A medical history of bleeding problems or recently taking blood thinners
A different type of anesthesia or pain control is more appropriate
Explanation of Benefits and risks of Nerve Blocks or Regional Anesthesia:
In addition to possible improved comfort, other benefits of nerve blocks include
improved breathing after certain operations (like abdominal or chest surgery) and earlier
mobility (such as getting out of bed). As with many procedures done in the hospital,
there are possible risks with nerve blocks. If an epidural or other nerve block is
suggested, we think the chance for you to benefit from the block exceeds the possible
risks. Both numbing medicine (like Novocain) and narcotic pain medicine (like
morphine) may be injected in a block. Some nerve block risks are unique to the block.
Other risks are unique to the narcotic or to the numbing medicine.
Narcotics have side effects and risks (such as nausea, itching, and slowed
breathing) that are possible regardless of the way they are given (shot, pills, or in
a block). There are some differences in the way these risks occur when the pain
medicines are given by nerve block. We carefully monitor you after surgery and have
the nurses follow very specific orders with your care.
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Below are some of the known risks possible with Epidurals, spinals, and nerve blocks.
Even though they are “the most common”, they are still quite rare. If you have any
questions or concerns, please discuss them with your Anesthesiologist. A Physician
Anesthesiologist is available 24 hours a day, 7 days a week to answer questions
that you, your family or nurse may have regarding your nerve block pain care.
OTHER RISKS OF REGIONAL or NERVE BLOCK ANESTHESIA
1) Headache – This risk is mainly associated, but infrequent with spinal
anesthesia. It may also occur with an epidural but is less likely. The risk of a
headache from a spinal or epidural is reported to be somewhere between 1
patient in 50 to 1 patient in 200.This risk is slightly more common the younger
you are or if you are a female.
2) Low blood pressure – This is usually brief and treated with medicines and IV
fluids.
3) Bleeding and infection – This is a very rare problem, but it could result in
nerve damage or require surgery to remove a blood clot or clean an infected
area. We use special guidelines to exclude people that have a higher risk of this
complication. Furthermore, sterile methods are used while placing nerve blocks
to minimize this risk.
4) Nerve Injury – This is a major concern of some patients considering nerve
blocks. The risk of a serious complication is between 1 patient in 10,000 blocks
to 1 patient in 40,000 blocks. We carefully place our blocks and monitor you to
help make sure you are treated as safely as possible.
5) Temporary weakness/numbness/tingling/warmth in the arms, legs, or
chest – This is directly related to the numbing medicine. Please tell your doctor
or nurse if you have these symptoms. Because your muscles may be weak and
make you fall, do not get out of bed or walk until you are told by your doctor or
nurse that it is safe to do so.
6) Mild Pain at the site of the block – This is usually mild and common for a few
days. This is expected to be much less than the pain from your surgery that you
would feel if you did not have a block. Always contact your doctor or nurse if
you experience severe pain.
7) Patchy or incomplete coverage of the surgical area – This is handled with
additional or different medication. We may stop the nerve block or Epidural and
change to one of the other ways of pain control listed earlier. We will take steps
to insure you are comfortable as quickly as possible.
8) Urinary retention (unable to urinate or pee) – This is more likely in older men
and those with a history of difficulty in urinating. You may need a temporary
bladder catheter to drain the urine for a day or two during your epidural care.
9) Seizure – While this is unlikely, it can happen when some of the numbing
anesthetic gets into or is absorbed into the blood stream rapidly. It does not put
you at risk for seizures in the future.
10) “High Block “– This is very rare and happens when the numbing medicine
temporarily blocks nerves needed for breathing. You are monitored closely for
this. Should this occur, you may require breathing help from a ventilator for a
short time (usually less than 1-2 hours).