Epidural anesthesia – summary of advantages and disadvantages

What is an epidural? All the knowledge in a nutshell!

Epidural anesthesia for labor is used to block pain in a specific part of the body. The procedure involves injecting anesthetics into the epidural space of the spine, resulting in loss of sensation of pain while leaving the patient conscious and able to interact.

During an epidural, the doctor anesthetizes the skin and then uses a thin needle to place a catheter through which anesthetics are administered. This allows for a controlled and continuous delivery of anesthetics, which is particularly useful in situations where the length of labor is unpredictable. This catheter is located in the epidural space of the spinal canal in the lumbar spine.

The entire procedure of administering an epidural for labor takes about 10 minutes. However, the analgesic effect can last up to 2 hours. If the labor action has not completed by then, the anesthesiologist administers more anesthesia through the catheter.

The use of this type of anesthesia in obstetrics has become very popular, as it provides effective pain relief during natural childbirth and cesarean section, allowing the mother to remain conscious and actively participate in the birth of her baby. However, it is worth noting that, like any medical procedure, epidural anesthesia is associated with certain complications, which should always be discussed with the attending physician.

Contraindications to epidural anesthesia include, but are not limited to:

• thrombocytopenia,
• Skin infection at the injection site,
• blood clotting disorders,
• hypertension,
• congenital heart defects,
• epilepsy,
• spinal degeneration.

Epidural anesthesia – where is it administered and when?

Epidural anesthesia is administered under local anesthesia into the spinal canal. As the anesthetic drug makes its way up and down the spinal cord, it blocks nerve conduction and, simply put, blocks pain. The anesthesiologist selects a thin needle and efficiently inserts it into the intervertebral space of the pregnant woman. A catheter is also usually inserted, through which further doses of anesthetic drug are administered if necessary.

Epidural anesthesia in childbirth must be given at the right time. There are two schools of thought about the timing of this anesthesia. Some argue that anesthesia just after labor begins can negatively affect the progress of labor. Others, on the other hand, believe that with a cervical dilation of more than 8 cm, it is too late for this. In general, epidural anesthesia during labor is administered until the cervical dilation is less than 10 cm, provided that the baby’s head is still deep in the birth canal and the labor action itself is not yet advanced.

There is another type of anesthesia that is often combined with this epidural in cesareans – namely, subarachnoid anesthesia. Of course, before each, the anesthesiologist administers local anesthesia with an ointment that induces only a cooling sensation. The doctor then asks to make a cat’s back and gently pokes into the spinal canal.

Positive effects of epidural anesthesia

The benefits of epidural anesthesia include:

• safety for mother and child,
• Minimal doses of anesthetics cause maximum action,
• Reduction of labor pain by 80%, which significantly increases the comfort of labor,
• anesthetics do not enter the bloodstream of the pregnant woman, so immediately after delivery you can breastfeed your newborn without fear,
• does not stupefy, the woman actively and consciously participates in the entire birth of her child,
• A woman after continuous epidural anesthesia is not as tired from the labor action as women who give birth naturally without anesthesia,
• quick return to form.

Read also: 24 week of pregnancy – what does the baby look like and how much does it weigh?

Epidural anesthesia – side effects, disadvantages and possible complications

In addition to the undoubted advantages, the administration of an epidural may also involve some disadvantages. These include:

• The risk of complications (e.g., slowing the progress of labor, or weakening of the lower extremities);
• a drop in a pregnant woman’s blood pressure, which can directly affect the heart rate of a tiny baby,
• severe dizziness,
• weakening of labor contractions requiring artificial administration of oxytocin,
• The high cost of the procedure,
• postpartum back pain.

With epidural anesthesia, complications are possible in the form of back pain at the prick site, slowed heart rate (bradycardia), problems with urination or vomiting. However, the side effects of epidural anesthesia can be much more serious. In rare cases, consequences such as:

• meningitis,
• Paralysis of the upper and lower extremities,
• A hematoma in the epidural space,
• anterior spinal artery syndrome.

A guide for moms-to-be – when to consider an epidural for childbirth?

• When a woman experiences severe pain that is difficult to bear. An epidural is often an effective way to relieve it.
• In cases where labor is prolonged, anesthesia can help the mother rest and gather strength for the stage of pushing the baby out.
• Epidural anesthesia is the preferred method of anesthesia in situations where the need for a cesarean section arises.
• Past experience with childbirth, health problems or other medical issues – it is not uncommon for these to influence the attending physician’s decision to choose this type of anesthesia.

However, it should be noted that this type of anesthesia should not be used right away. Every woman should have the chance to first benefit from non-pharmacological methods of pain relief that are neutral to the course of labor.

FAQ:

• What are the side effects of epidurals?

Complications are unfortunately often associated with this type of procedure. We can include, among others: severe dizziness, postpartum back pain, a drop in the blood pressure of the pregnant woman, a slowdown in the progress of labor, or weakness (and sometimes paralysis) of the lower limbs.

• Is it safe to use an epidural?

Epidural anesthesia for childbirth is considered safe for both mom and baby.

• Epidural anesthesia – how long does it last?

The use of epidural anesthesia in the correct way can provide relief to the patient throughout labor. After the drug is administered, the initial effects usually appear within a few minutes, and its full effect is usually achieved within 10-20 minutes.