Epidural anesthesia (aka epidural) -an excellent way to take away the pain during labor and delivery. Like most invasive treatments, in this procedure, there are advantages and disadvantages, but it is relatively safe and has significant advantages over general anesthesia, as for this type of anesthesia used much lower doses of drugs. Epidural anesthesia causes less harm to the cardiovascular system, as it operates only on the lower part of the body to relieve pain. There are indications that this should not be used anesthesia, namely:
- patients with bleeding disorders;
- patients suffering from coagulopathy;
- long-term use aspirin or non-steroidal anti-inflammatory drugs;
- hypovolemic shock;
- placental abruption;
- infection in the area of the catheter;
- persistent headache;
- back pain (not related to the pregnancy);
- chronic neurological disorders;
- allergy to drugs used for anesthesia;
- certain heart disease (if you have a heart condition, be sure to discuss this with your anesthetist);
- failure to cooperate with the introduction and installation of the catheter during the procedure;
- inability to talk about the power of pain or problems encountered;
- on the site of the catheter scar from spinal surgery;
- curvature of the spine of the patient.
Before considering the possibility of applyingthis method, MirCovetov readers should keep in mind that you just do not know about the presence or absence of some of the above contraindications. This is due both to the lack of a complete examination, and with the individual structure of each organism.
It is very important that you understand all risks beforedeciding that epidural anesthesia for you. Though very small, but still there is a risk of infection or neurological injury. You and your family should discuss all possible problems before you sign consent for the procedure. If you do not understand the possible dangers, or how is the procedure - epidural anesthesia is not for you.
What is an epidural?
Epidural anesthesia - one of the methodsanesthesia, in which drugs are administered in small doses to the epidural space of the spine via the catheter. It blocks pain in the nerve endings of the birth canal and uterusWithout stopping at the same generic process itself. The successful epidural anesthesia ensure almost painless during labor and the birth of your child.
Most obstetricians are considering the possibility of epidural anesthesia, only if requested by the very woman in labor.
women with hypertensionVery dangerous disease, doing a Cesareansection. Because epidural anesthesia carries mostly emotional burden. But this pressure is not reduced in the arteries. Eclampsia, as well as pre-eclampsia, are an absolute indication for operative delivery.
This procedure is carried anesthesiologist -a physician who specializes in the means and methods of providing anesthesia. Before introducing the drug, your generic process is carefully watched. Next to you will always be a trained specialist, up to the birth of the child.
How does this happen?
Epidural anesthesia is not usually used,until you enter the active stage of labor. You will be asked to lie on your left side, the most pressing his chin to his chest and knees, or sit down, his head bowed and shoulders, and arms stretched forward - in this position easily identified by the middle line of the back. The sitting position is preferable because it allows the anesthesiologist easier to view anatomical landmarks. The lower part of the back is treated with a disinfectant solution in order to reduce the risk of getting infections. At some point in the lower back portion anesthetize the skin the size of a five-ruble coin via topical analgesic. You must lie down as calmly as possible, while in the epidural space of the spinal cord by inserting a needle larger. Small thin tube (catheter) is carried out until the needle until it reaches the desired location. Then carefully remove the needle itself. Then enter "test dose" of the drug to verify the placement of the catheter. If the catheter is inserted incorrectly, it speeds up the heart rate. If the heartbeat is normal, you are administered the first dose of anesthetic. The catheter is fixed to the back of your order to add the drug as needed. Fixed a catheter does not restrict your movements and does not feel on his back.
Analgesic enters the epidural space, where the nerve endings, which get pain impulses in the spinal cord. The drug blocks the momentum before it gets to the brain.
After 3-5 minutes after the first dose,blocked nerve impulses that transmit pain signals in our brain. Full effect occurs within 10 minutes, you should not feel pain at all. After the first dose of action will weaken, you will add the next portion. Typically, the drug is administered at intervals of 2 hours, but it also depends on the drug.
After the baby is born, the catheter is removed. anesthetic effect usually extends completely after 1-2 hours. Then you can experience a burning sensation in the genital tract area.
Is epidural anesthesia is safe?
Currently it is believed that epiduralAnesthesia is completely safe for mother and child. But, of course, the risk is always there. Epidural anesthesia can cause complications (such as forceps baby), which is also risky. The most common side effect - a sudden drop in blood pressure in pregnant woman. This problem occurs in 1-2% of cases and is dangerous for women and children. If it suddenly happens, team doctors need to take urgent action. In most cases, the situation is stabilized. Monitoring the blood pressure level required after each drug administration.
Other possible complications:
- the needle is inserted correctly and epidural anesthesia does not relieve the pain;
- loss of control of urination, because of which may require the introduction of a catheter;
- paralysis of the back with the introduction of the anesthetic into the spinal space. breathing and a sudden stop pressure decrease. This is - a serious condition.
Always Does an epidural work?
If the doctor can not easily determinelocate the epidural space, the use of this type of anesthesia is unacceptable. But this rarely happens. Sometimes labor begins so fast that the time to anesthesia simply does not remain. In some cases, the anesthetic site of action: one part numb, others - no.
Epidural anesthesia can be performedthe majority of women, but again the same with the exception of contraindications (this requires a complete examination). MirSovetov recalls that everyone undergoing surgery on his back, with heart disease, blood or allergic to certain painkillers necessarily need to discuss these issues with your doctor and anesthesiologist.
Advantages of epidural anesthesia:
- pain relief during labor, delivery and, if necessary, an episiotomy;
- reducing the period of cervical dilatation;
- the elimination of pain, and in the consciousness of mothers remains clear;
- the drug enters the bloodstream child in such small quantities that it can not cause significant bad effect on his condition.
- the mother must stay in a supine position on the entire delivery period;
- mother has no control over his body and could notIt feels the process of childbirth. This may affect the relationship between mother and child. The second stage of labor may be delayed due to the inability of the mother to move around and use the force of gravity;
- a woman in labor is totally dependent on caregivers, and can not itself to celebrate their physiological needs. Most likely, the new mother will need the introduction of a urinary catheter, which carries certain risks;
- most frequent "bad" consequences for the baby - a weak breath (if the correct dosage is counted, then the damage to the minimum).
- rare, but still there are very serious problems, and that a woman in labor, and her family should be warned.
How else can relieve pain of childbirth?
There are other ways to reduce pain. Many women help techniques learned in courses for young mothers - relaxation, massage, certain poses, visualization, distraction, breathing exercises, done with the support of another person. All this is based on your own strength and endurance, but quite successfully allows you to control your body.
Epidural anesthesia - just one method thatcan provide relief from the pain and discomfort during labor. It really requires a lot of trust in the medical staff. It really is quite risky. The final decision to accept you. An understanding of the procedure and its implementation will help to determine what is right and necessary for you.