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Epidural pain relief after major cancer surgery | CION Cancer Clinics
An epidural is a very thin tube placed in your back that carries numbing medicine close to the nerves of the chest or abdomen. After a large open operation, it can block much of the wound pain for the first few days while you stay awake and clear-headed. It is not suitable for everyone. This page explains how it is placed, what it feels like and what to report. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What does an epidural do for pain after major surgery?
- How is the epidural put in, and taken out?
- What does it feel like to have an epidural running?
- Who is an epidural not suitable for?
- What worries do people have about epidurals, and what is true?
- What do the ward words about epidurals mean?
- Common questions about epidurals after surgery
The short answer
What does an epidural do for pain after major surgery?
An epidural is a very thin, soft tube placed in your back that carries numbing medicine close to the nerves of the chest or abdomen. For the first few days after a large open operation, it can block much of the wound pain while you stay awake and clear-headed.
How it differs from other pain relief
Drip medicines and tablets travel through the whole body. An epidural works on the nerves that carry pain from the operated area. That often means less need for strong painkillers, and so less drowsiness, feeling sick and constipation. Many people find it easier to breathe deeply and cough, which helps protect the lungs.
When it is usually offered
It is mostly used after large open operations on the abdomen, the chest or the pelvis, such as surgery on the food pipe, stomach, pancreas, bowel or lung. After keyhole surgery or smaller operations, other methods usually work well enough and an epidural is less often needed.
Epidural and spinal are not the same
A spinal is a single injection that numbs the lower body for a few hours. An epidural leaves a tube in place, so the medicine can keep running for days.
Whether an epidural is right for you is decided by your anaesthetist, who will explain the choice at your check before surgery.Start to finish
How is the epidural put in, and taken out?
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In the operating theatre, before you sleep
The epidural is usually placed just before the general anaesthetic. You sit on the edge of the bed and curl forward, or lie on your side with your knees drawn up. A nurse helps you hold still.
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A numbing injection first
The skin on your back is cleaned, which feels cold, and a small injection numbs it. You then feel pressure as a needle guides the tube into place, and the needle is removed. Tell the anaesthetist if you feel a sharp pain or tingling down a leg.
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The tube is taped up your back
Only the thin tube stays in. It is taped along your back to the shoulder and connected to a pump. You can lie on it without damaging it.
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On the ward
The pump runs steadily, and some pumps let you press for an extra amount. Nurses check your blood pressure, how numb you are, your leg strength and the site in your back several times a day.
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Taking it out
After a few days you move to tablets. The tube slides out in a second and does not hurt. If you take a blood thinner, the team times the removal carefully around your dose.
Not sure whether this applies to you?
Ask an oncologistWhile it is running
What does it feel like to have an epidural running?
Most of these are expected. Knowing about them in advance makes them far less frightening.
Numbness over the wound
A band of skin around the operated area feels numb or cool. Nurses test this with an ice cube or cold spray to check the epidural is reaching the right level.
Heavy or tingly legs
Your legs may feel warm, heavy or slightly weak. You may be helped to sit out or walk with support. Tell the nurse if your legs become very weak or numb.
Light-headedness
The medicine can lower blood pressure, so you may feel faint when you sit up. Nurses may slow the pump or give fluids. Always get up slowly and with help.
A catheter for urine
An epidural can make it hard to feel when your bladder is full, so a urine catheter is usually kept in while it runs.
Also common
- Itching
- A patch of pain the epidural misses
- Tenderness where the tube went in
Being straight with you
Who is an epidural not suitable for?
An epidural is not safe or useful for everyone. When it is not suitable, the anaesthetist uses other methods, such as a PCA pump or nerve blocks, and these can also control pain well.
Reasons it is often avoided
It is usually avoided in people taking certain blood thinners, people with a low platelet count or a bleeding problem, and people with an infection in the skin of the back or in the blood. It can be harder or riskier after previous spine surgery, with severe curvature of the spine, or with some heart valve problems. Some people simply do not want one, and that is their choice.
Blood thinners need planning
If you take aspirin, clopidogrel, warfarin or a newer blood thinner, tell the team early. The surgeon, anaesthetist and the doctor who prescribed it will decide whether and when it is paused. Never stop it on your own to make an epidural possible.
What this page cannot tell you
It cannot tell you whether an epidural is planned for your operation. Serious problems are rare, but they do exist, and your anaesthetist can explain them in relation to your own health.
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Commonly believed
What worries do people have about epidurals, and what is true?
"An epidural will leave me with back pain for life."
The place where the tube went in can be bruised and tender for a few days. Long-term back pain after an epidural is not common. Back ache after surgery more often comes from lying still on an operating table and in bed.
"It can paralyse you."
Lasting nerve damage is very rare. It is the reason nurses check your leg strength regularly, so any warning sign is picked up early. Ask your anaesthetist to talk you through the risks for your own situation.
"If one side is not numb, the epidural has failed."
Patchy numbness is quite common and can often be fixed by changing your position, adjusting the tube or giving a top-up. Tell the nurse rather than putting up with it.
"You cannot get out of bed with an epidural."
Many people sit out and take short walks with help while it runs. Moving early is encouraged, and the epidural often makes it easier.
Words you may hear
What do the ward words about epidurals mean?
- Epidural space
- A thin layer inside the spine, just outside the covering of the nerves. The tube sits here, not in the spinal cord.
- Local anaesthetic
- The numbing medicine, often bupivacaine or ropivacaine. A small amount of an opioid such as fentanyl is sometimes mixed in.
- Block height
- How far up and down the body the numb band reaches. Nurses test it with something cold.
- Top-up
- An extra dose through the tube when pain breaks through.
- Thoracic epidural
- An epidural placed higher in the back, used for chest and upper abdomen operations.
!
Tell the team the same day
While the epidural runs, or in the days after it comes out, report at once: new or worsening weakness or numbness in the legs, severe back pain at the tube site, redness, pus or fever with back pain, or losing control of the bladder or bowels. On the ward, call the nurse. At home, call the surgical team or go to the nearest emergency department. Do not wait to see if it passes.
Questions we are asked
Common questions about epidurals after surgery
Does putting in an epidural hurt?
The skin is numbed first, so most people feel a brief sting and then pressure. It is uncomfortable more than painful. Tell the anaesthetist if you feel a sharp pain or tingling in a leg, because the needle can be adjusted. Holding still matters, so a nurse helps you.
Will I be awake when it is put in?
Usually yes, because you need to tell the anaesthetist what you feel. You may be given something to help you relax. The general anaesthetic for the operation is started once the epidural is in place.
Is this the same epidural women have in labour?
It works in the same way, but it may be placed at a different height in the back and run for longer, depending on where your operation is. The medicines are similar. After surgery it is part of a wider pain relief plan.
Why do I need a urine catheter with it?
The numbing medicine can stop you feeling when your bladder is full, and it can make passing urine difficult. A catheter prevents the bladder overfilling. It is usually removed once the epidural is stopped and you can pass urine on your own.
What happens if the epidural does not work well?
Tell the nurse. The anaesthetist may give a top-up, adjust the tube or change your position. If it still does not cover the pain, it can be removed and replaced with a PCA pump or other medicines. You should not be left in pain.
Can I eat and drink with an epidural running?
The epidural itself does not stop you eating. When you can eat depends on your operation, and your surgeon decides that. Some people find the gut wakes up a little sooner with an epidural, because less strong painkiller is needed.
Will the tube in my back fall out if I lie on it?
It is taped firmly and you can lie on your back normally. It can occasionally slip if the dressing becomes loose or wet. If you notice the tape lifting, a wet dressing or a disconnected line, tell the nurse rather than fixing it yourself.
Is an epidural included in the surgery cost or my scheme?
Pain relief on the ward is usually part of the operation package under Aarogyasri, CGHS, ECHS, EHS and most cashless insurance plans. Package details differ, so ask the billing desk before admission what your own cover includes.
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Sources
- NHS — Epidural
- NHS — Local anaesthesia
- National Cancer Institute — Cancer pain
- American Cancer Society — Cancer surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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