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First, an intravenous line will be placed, generally in your hand. We will then bring you to the operating room and place several monitors on you, such as a heart, blood pressure and a pulse. These will enable us to monitor your vital signs throughout the procedure. Following placement of the monitors we will begin to give you some intravenous medication in order to decrease anxiety, as well as provide you with some pain relief.
You will then be asked to either sit or lie on your side on the bed. Sometimes, x-ray guidance aids in the appropriate placement of the catheter, and an x-ray may be used.
After cleaning a small patch of skin along your spine, a local anesthetic is injected into the skin to decrease any pain associated with the placement of the catheter. A small needle is then used to locate the epidural space, and the catheter is threaded through the needle. The needle is then withdrawn and a second patch of skin is anesthetized with local anesthetics.
A similar needle is placed in the second spot in order to bring the catheter from the middle of your back to the side. This allows the catheter to be tunneled underneath the skin for a distance of four to five inches in order to provide stability. Two or three stitches may be placed to secure the catheter. The catheter is then covered with sterile dressing and taped to the skin of your back. The procedure itself is very brief, and associated with minimal discomfort.