If the epidural catheter has been inserted in the lower part of your back, it will block the lower part of your abdomen or your legs. Depending on the concentration of local anaesthetic used, you may or may not have control over the muscles in your legs. If the concentration is kept low or weak, only nerve fibres that transmit pain can be blocked, while nerves that go to muscles remain unblocked so that the muscles can function normally.
If the concentration of the local anaesthetic is stronger (e.g. if the surgery is very painful), you will have to accept that not only pain will be removed, but also some of the power of the muscles in your legs. In this case it is of course not possible or advisable to get out of bed.
If the epidural catheter is inserted higher up in the back, at thoracic level (for surgical procedures in the upper abdomen or chest), the innervation of the legs will not be affected, even if strong concentrations of local anaesthetic are used. In this case it is possible and even advisable to get out of bed. One of the advantages of epidural analgesia is that it allows early ambulation – in other words, sitting in a chair or going for a short walk – which decreases the risk of clot-forming in the veins (venous thrombosis) and improves lung function.
Reviewed by Prof CL Odendal, senior specialist at the department of anaesthesiology at the University of the Free State, April 2010.nction.
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