LET’S TALK ABOUT EPIDURAL ANESTHESIA

Epidural anesthesia is the most popular method of pain relief during labor. Women request an epidural by name more than any other method of pain relief. More than 50% of women giving birth at hospitals use epidural anesthesia.

As you prepare yourself for “labor day,” try to learn as much as possible about pain relief options so that you will be better prepared to make decisions during the labor and birth process. Understanding the different types of epidurals, how they are administered, and their benefits and risks will help you in your decision-making during the course of labor and delivery.
Epidural anesthesia is the most popular method of pain relief during labor. Women request an epidural by name more than any other method of pain relief.

WHAT IS EPIDURAL ANESTHESIA
Epidural anesthesia is a regional anesthesia that blocks pain in a particular region of the body. The goal of an epidural is to provide analgesia, or pain relief, rather than anesthesia, which leads to total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments. This results in decreased sensation in the lower half of the body.

Epidural medications fall into a class of drugs called local anesthetics, such as bupivacaine, chloroprocaine, or lidocaine. They are often delivered in combination with opioids or narcotics such as fentanyl and sufentanil in order to decrease the required dose of local anesthetic.

This produces pain relief with minimal effects. These medications may be used in combination with epinephrine, fentanyl, morphine, or clonidine to prolong the epidural’s effect or to stabilize the mother’s blood pressure.

HOW IS AN EPIDURAL GIVEN
Intravenous (IV) fluids will be started before active labor begins and prior to the procedure of placing the epidural. You can expect to receive 1-2 liters of IV fluids throughout labor and delivery. An anesthesiologist (specialize in administering anesthesia), an obstetrician or nurse anesthetist will administer your epidural.

You will be asked to arch your back and remain still while lying on your left side or sitting up. This position is vital for preventing problems and increasing the effectiveness.

HOW IS AN EPIDURAL GIVEN

An antiseptic solution will be used to wipe the waistline area of your mid-back to minimize the chance of infection. A small area on your back will be injected with a local anesthetic to numb it. A needle is then inserted into the numbed area surrounding the spinal cord in the lower back.
After that, a small tube or catheter is threaded through the needle into the epidural space. The needle is then carefully removed, leaving the catheter in place to provide medication either through periodic injections or by continuous infusion.The catheter is taped to the back to prevent it from slipping out.

WHAT ARE THE BENEFITS Of EPIDURAL ANESTHESIA

1. Allows you to rest if your labor is prolonged.

2. By reducing the discomfort of childbirth, some women have a more positive birth experience.

3. Normally, an epidural will allow you to stay alerted and remain an active participant in your birth.

4. If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery.

5. When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability, and fatigue. An epidural can allow you to rest, relax, get focused, and give you the strength to move forward as an active participant in your birth experience.

When can an epidural NOT be used?

An epidural may not be an option to relieve pain during labor if any of the following apply:

1. You use blood thinners

2. Have low platelet counts

3. Are hemorrhaging or in shock

4. Have an infection on or in your back

5. Have a blood infection

6. If you are not at least 4 cm dilated
Epidural space can not be located by the physician
If labor is moving too fast and there is not enough time to administer the drug.

Questions to ask your healthcare providers now and at the time of delivery in the hospital:

1. What combination and dosage of drugs will be used?

2. How could the medications affect my baby?

3. Will I be able to get up and walk around?

4. What liquids and solid foods will I be able to consume?

 

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