On the day of the injection you will need to have been starved ‘nil by mouth’ from midnight. On admission Mr Ishaque and Dr E J Da Silva will see you in order to go through the consent and talk you through the procedure.
You will then be taken down to the anaesthetic room where you will greeted by the theatre team and all the necessary checks will be performed for your safety. At this stage Dr Da Silva will place a small cannula in the back of your hand to allow him to deliver the anaesthetic agents during the procedure.
You will then be walked into the theatre itself and shown how to climb onto the operating table in order to get comfortable.
I will then mark your back with a marker pen using the x-ray machine to guide him regarding the entry point for the spinal injections. I will then clean your back using standard surgical iodine and the procedure is carried out using a sterile technique.
You may feel a slight sharp sensation like a pinch which last a few seconds before Dr Da Silva administers the intravenous general anaesthetic which is the local anaesthetic being placed at the needle entry point but often you will already be asleep at this point. You will not feel the actual spinal injection which is much more comfortable and safer for yourself and Mr Ishaque, as he can be sure you will not move at a crucial point during the injection.
Please be aware that if you are needle-phobic (very scared of needles) then Dr Da Silva can make sure that you will not even feel this initial injection just under the skin.
Mr Ishaque routinely performs an epidurogram using either Omnipaque or Niopam in order to confirm correct placement of the spinal needle after using x-ray guidance in two planes, taking x-rays from both side to side and from front to back.
Once you have had your injection you will be helped back onto your bed and transferred to the recovery suite. As you have had an epidural injection it is standard practice to monitor your blood pressure for about half an hour before being sent back to the ward.
Once back on the ward you will be able to eat and drink in order to get your blood sugar levels up and you will be asked to rest for 90 minutes to allow the sensation to return to your legs and the effects of the general anaesthetic to wear off.
Usually you will be discharged by about 3pm and you will need to be picked up, as you will not be fit to drive on the day of the injection.