Using Epidural Anesthesia During Labor: Benefits and Risks
Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body and it’s the most popular method of pain relief during labor. Women request an epidural by name more than any other method of pain relief. The goal of an epidural is to provide analgesia, or pain relief, rather than anesthesia, which leads to a total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments. More than 50% of women giving birth at hospitals use epidural anesthesia.
Types of epidurals?
After the catheter is in place, a combination of a narcotic and anesthesia is administered either by a pump or by periodic injections into the epidural space. A narcotic such as fentanyl or morphine is given to replace some of the higher doses of anesthetic.
Combined Spinal-Epidural (CSE) or “Walking Epidural”
An initial dose of narcotic, anesthetic, or a combination of the two is injected beneath the outermost membrane covering the spinal cord, and inward of the epidural space. This is the intrathecal area. The anesthesiologist will pull the needle back into the epidural space, thread a catheter through the needle, then withdraw the needle and leave the catheter in place. This allows more freedom to move while in the bed and a greater ability to change positions with assistance. With the catheter in place, you can request an epidural at any time if the initial intrathecal injection is inadequate.
With the use of these drugs, muscle strength, balance, and reaction are reduced. CSE should provide pain relief for 4-8 hours.
Benefits of Epidurals During Delivery
- Potential for a painless delivery.
- Allows you to rest if your labor is prolonged.
- By reducing the discomfort of childbirth, some women have a more positive birth experience.
- Required in cesarean delivery. will allow you to stay awake and also provide effective pain relief during recovery.
Risks of Epidurals During Delivery
- Low blood pressure: About 14 percent of women who get an epidural block experience a drop in blood pressure. Although it’s usually not harmful. Your blood pressure will be closely monitored. If necessary, fluids and medication can be passed through a drip to keep your blood pressure normal.
- Loss of bladder control: After having an epidural, you may not be able to feel when your bladder is full because the epidural affects the surrounding nerves. You may have a catheter inserted to empty your bladder for you. You should regain bladder control once the epidural wears off.
- Nausea and vomiting: Opioid pain relievers can sometimes make you feel sick to your stomach, a ringing of the ears, backache, and soreness when the needle is inserted
- Fever: Women who get an epidural sometimes run a fever. About 23 percent of women who get an epidural run a fever, compared to about 7 percent of women who don’t get an epidural. The exact reason for the spike in temperature is unknown.
- Permanent nerve damage: In rare cases, an epidural can lead to permanent loss of feeling or movement in, for example, one or both legs.
Other very rare complications of an epidural include:
- fits (convulsions)
- severe breathing difficulties
When can an epidural NOT be used?
- You’re Taking Certain Medications
- You’re Bleeding Heavily
- Have low platelet counts
- Are hemorrhaging or in shock
- Have an infection on or in your back
- Have a blood infection
- If you are not at least 4 cm dilated
- Epidural space cannot be located by the physician
- If labor is moving too fast and there is not enough time to administer the drug
- Your Blood Work Isn’t Just Right
- Labor Restrictions
Before deciding to have an epidural, you should discuss the procedure with your anesthetist about the advantages and disadvantages of each technique. Medication provides the greatest pain relief, but it can cause side effects. Make the decision based on your personal preferences and ability to tolerate pain.
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