Understanding Anesthesiology - The Global Regional Anesthesia ...

Epidural Anesthesia
Epidural and spinal anesthesia can be used for procedures
involving the abdomen, perineum or lower extremities.
The two blocks differ by virtue of the anatomic
space into which local anesthetic (LA) is delivered.
Understanding the anatomy of the region (Figure
10, Figure 11) is crucial to understanding the blocks.
Figure 11 Anatomy relevant to epidural anesthesia
Figure 10 Ligamentous anatomy of the spine
From “Introduction to Regional Anaesthesia” by D. Bruce Scott
(1989). Used with permission from his wife, Joan and son, Nicholas
B. Scott.
From “Introduction to Regional Anaesthesia” by D.
Bruce Scott (1989). Used with permission from his
wife, Joan and son, Nicholas B. Scott.
In epidural anesthesia, a tiny plastic catheter is placed
into the epidural space, which is the anatomic space located
just superficial to the dura. An epidural catheter
can be placed at any point along the spinal column.
Epidural catheters placed for surgical anesthesia or analgesia
are most commonly used at the thoracic or lumbar
regions depending on the site of the surgery. A LA
solution is delivered through the catheter. From the
epidural space, it is slowly absorbed into the subarachnoid
space where it blocks the nerves of the spinal cord
50