Many people associate epidurals with childbirth, but in reality 80% of epidural injections are given outside of labor & delivery. Every year, nearly 9 Million epidurals are given to patients as a part of their pain management treatment, either to mitigate pain during or after surgery or as part of a plan to address inflammation that may cause chronic pain.
Typically administered by anesthesiologists, epidurals involve the injection of an anesthetic near the spinal cord to block pain from an entire region of the body. There are several types of epidurals (lumbar, thoracic, and cervical) that are delivered at different points in the epidural space, to provide continuous pain relief in a corresponding area, such as the belly, hips, legs, or pelvis.
While epidurals are considered to be both safe and effective, it is reported that 13% of epidurals result in unsuccessful or incomplete anesthesia as well as other patient side effects. Increasing trends toward patient obesity can make it more difficult to correctly identify the epidural space. In fact, 74% of obese patients needed more than one attempt for successful epidural needle placement.
Some doctors leverage fluoroscopy guidance to confirm they have correctly identified the epidural area. While generally accurate, fluoroscopy is similar to an x-ray and presents a radiation risk to both the patient as well as the medical team performing the procedure. Additionally, in an effort to limit radiation exposure, the fluoroscopy guidance is done intermittently and therefore does not provide real time continuous feedback to the clinician.