Spinal cord stimulation (SCS) is used to treat chronic pain and requires an awake patient for optimized lead positioning to locate paresthesias. Epidural anesthesia may be a suitable anesthetic but has not been evaluated. METHODS: We performed an open-label, prospective, observational, single-center study to evaluate the safety and efficacy of laminectomy lead placement under epidural anesthesia for the treatment of neuropathic chronic pain. RESULTS: The results in our study demonstrate that epidural anesthesia is a suitable technique for SCS lead implant. CONCLUSIONS: This is the first study using epidural anesthesia for SCS lead implants by laminectomy. The technique seems to be safe and effective. (Anesth Analg 2007;105:1458-61)