Epidural anaesthesia involves the injection of medication into the epidural space (outside the dura mater) to block nerve transmission. It is a cornerstone of both obstetric pain management and postoperative analgesia.
Clinical Features and Technique
| Feature | High-Yield Point |
|---|---|
| Mechanism | Acts primarily on nerve roots exiting the dura mater. |
| Catheter | Allows for continuous infusion or repeat dosing; ideal for prolonged surgeries or labor. |
| Placement | Identified by the “loss of resistance” technique using saline or air. |
High-Yield NEET PG Clinical Points
- Clinical Benefit: Reduces the need for systemic opioids and lowers the risk of postoperative respiratory complications and myocardial infarctions.
- Obstetric Use: More effective than IV/oral opioids; does not increase the risk of Caesarean section.
- Accidental Dural Puncture: Can lead to a “total spinal,” causing unconsciousness and respiratory arrest.
- Post-Dural-Puncture Headache (PDPH): Treated with an epidural blood patch if conservative measures fail.
Clinical High-Yield Contraindications
Epidural anaesthesia is contraindicated in patients with severe coagulopathy, local infection (cellulitis) at the site, or uncorrected hypovolemia. Use caution in patients with preexisting progressive neurological disease.
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