Patient Information
Potential Risks and Complications of Epidural Anaesthesia
It is important to remember that epidurals in labour and childbirth are very safe. However, as with any other medical procedure, epidurals have potential complications and side effects. You should consider these side effects as well as the benefits of epidural analgesia. Please discuss any concerns or questions with your Anaesthetist prior to inserting the epidural. For additional information on the rates of side effects from epidurals please click here.
More Common:
- Low blood pressure is the most common side effect associated with having an epidural. This is because the medication given via the epidural, affects the nerves that go to your blood vessels, which causes a fall in blood pressure - your blood pressure will be closely monitored. Fluids and/or medication may be given to treat the blood pressure.
- Light-headedness and dizziness - generally as a result of a lower blood pressure.
- Nausea and vomiting - due also as a result of a lower blood pressure.
- Temporary leg weakness or heaviness - this is due to the effect of the local anaesthetic on nerves which control leg movement. The effect is temporary and wears off within several hours.
- Urinary retention - Generally speaking, you will require a urinary catheter after the epidural is placed. A catheter will be inserted into your bladder to allow urine to drain away. Your bladder control will return to normal as soon as the epidural wears off.
- Shivering - is very common and is due to the epidural medication. It is of no medical consequence and no treatment is needed. Shivering is temporary and will wear off within several hours.
- Itchy skin - is also of no medical consequence and is generally treated conservatively.
Less Common:
Post-dural puncture headaches - caused when the lining of your spinal cord (dura) is accidentally punctured during insertion of the epidural. When the dura is punctured, the fluid inside will leak out, resulting in a fall in the pressure of your brain and spinal cord. The decrease in pressure can lead to a persistent and severe headache. The headache symptoms will resolve when the puncture hole is sealed. Whilst most headache symptoms will settle in a few days, occasionally there may be a need to perform a procedure known as a 'blood patch' to seal up the hole. It involves taking a small sample of your own blood and injecting it into the epidural space. When the blood clots, the hole will be sealed and your headache will stop. Post-dural headaches are uncommon following an epidural. There is a 1 in 100 to 1 in 500 chance of it happening. Please note, for women that have had an epidural, not all headaches, during and after labour are because of a post-dural puncture. There are many other causes including tension headache, migraines
and preeclampsia.
Click here for further information on post-dural headache
Very Rare:
- An epidural abscess is an infection (a collection of pus) that forms in the tissue that surrounds the spinal cord. The abscess may surround the spinal cord and cause enough pressure to affect neurological function. The treatment for an epidural abscess is surgical drainage and intravenous antibiotics.
- An epidural haematoma is a collection of blood within the epidural space, which can result in spinal cord compression. Treatment will generally require surgical decompression.
- 'Pins and needles', numbness or weakness can sometimes persist after epidural or spinal anaesthesia. In approximately 1 patient in 10,000 this may be long lasting or even permanent.