Lumbar epidural blocks may be indicated for selected cases in day surgery; either by special request from the patient, prolonged or unpredictable duration of surgery, or caudal blocks for prolonged postoperative pain control in children. The drawbacks of epidural anesthesia, such as preoperative time consumption, may be minimized by introducing the epidural block by slow injection through the needle in the holding area, not using a test dose, and immediate preparation of the operating site before the effect of the block is evident. A mixture of lidocaine 15 mg/mL with epinephrine is recommended. After eliminating any possibility of spinal tap, 14 to 16 mL should be slowly injected through the needle during 2 to 3 minutes, while continuously checking the patients for any symptoms of inadvertant spinal or intravascular injection. After injection, an epidural catheter may be slowly advanced 2 cm into the epidural space for further adjustments of the block, if necessary. Copyright © 2000 by W.B. Saunders Company