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Epidural Anesthesia
The epidural is administered with a very small plastic catheter that is inserted through a needle in the lower part of the back, in the pidural space, which are the hardest membranes that cover the spinal marrow. Before inserting the needle, the anesthesiologist desensitizes the skin and the soft tissues under it with local anesthesia. After placing the needles, the anesthesiologist passes a plastic catheter through it. In that moment it possible the woman will feel a brief sensation of tickling in the legs, but the process is not painful if the local anesthesia has been placed correctly in the skin and the subjacent tissues. The medications are then administered through the catheter that desensitizes the nerves that go to the uterus, the vagina and pelvis. The catheter remains in place during the labor and can be used multiple times in case a reinforcement doses were needed so that the anesthesia lasts during the whole labor and delivery, and even to manage the pain if necessary. The modern advancement in anesthesia allow making a sensitive blocking that takes away the hard work of labor without blocking movement, meaning the woman can still move. Occasionally, and depending on the doses used, it is possible there will be a certain sensation of weakness in the legs, but this does not block movement, and it temporal. The amount and type of medication that is needed can be adjusted according to the stage of the labor. During the first stage, the relief of pain concentrates on the uterine contractions, in the second stage, the relief of pain focuses on the vagina and hind area, which are distended so that the baby passes through. Another benefit of the epidural is that the mother is able to rest and breath slower because she no longer feels pain, therefore she and the baby are getting more air, which is an advantage. The epidural can also relieve the pain of a cesarean, although in those types of cases, different doses are used. Since it allows the mother to be awake during the delivery and allows her to live the experience of the birth of the baby, it is very popular in cesareans. In the cases in which the procedure presents itself as an extreme emergency or if the mother has problems coagulating it will not be possible to use an epidural. It was once believed that when epidurals, especially if they were administered too quickly, made the process of labor longer and increased the need to use forceps, extraction systems, or cesareans. And because of this reason, a lot of doctors were against recommending them to their patients. Nowadays however, most doctors accept that these problems are not likely if the epidural is administered by a competent anesthesiologist and the process of labor is already well established, and they affirm that the benefits outweigh the risks. There are also occasions in which the epidural will take away the feeling of having a full bladder that a lot of women have, therefore it is possible you will also need of a catheter to empty the bladder. In other occasions it can block sensitive nerves, to the point in which the woman doesn’t feel like pushing and in these cases, the doctor will need to tell the woman when to. In general, managing pain makes it possible for both the mother and her husband or partner to enjoy the experience of labor and the delivery more. Epidurals are something that should be considered when the pain can no longer be managed. Combined Spinal-Epidural Anesthesia |
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