How does epidural anesthesia affect the heart? Epidural anesthesia for caesarean section - all the features of anesthesia

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What is epidural anesthesia?

Epidural anesthesia is the injection of pain medications into the lumbar region through a catheter. This is a regional anesthetic because the drugs only act on the nerves that carry signals from the part of the body that is experiencing pain during labor. As a result, the abdominal area loses sensitivity, and you, in turn, do not feel any http://www.babycenter.ru/a1041506/%D0%BD%D0%B0%D1%82%D1%83%D1%80% D0% B0% D0% BB% D1% 8C% D0% BD% D1% 8B% D0% B5-% D1% 81% D1% 80% D0% B5% D0% B4% D1% 81% D1% 82% D0 % B2% D0% B0-% D0% BE% D0% B1% D0% B5% D0% B7% D0% B1% D0% BE% D0% BB% D0% B8% D0% B2% D0% B0% D0% BD% D0% B8% D1% 8F-% D0% B2% D0% BE-% D0% B2% D1% 80% D0% B5% D0% BC% D1% 8F-% D1% 80% D0% BE% D0 % B4% D0% BE% D0% B2.

How is epidural anesthesia done?

First, your anesthetist will give you an injection of a local pain reliever in your lower back. He will then insert a hollow needle between the vertebrae.

The needle enters the space between the dura mater of the spinal cord and the periosteum of the vertebrae called the epidural space. A catheter is then inserted through the needle.

After insertion of the catheter, the needle is removed. The catheter tube is led out along your back and over your shoulder.

Epidural pain relievers are administered in several ways:

• Pain relief followed by an increase in dose. The anesthesiologist will inject you with a mixture of pain relievers to stop pain in your lower abdomen. If the anesthesia works, you will not feel the contractions. As the epidural wears off, your doctor may give you additional doses that last for another hour or two.
• Continuous introduction. The doctor will insert the catheter. The other end of the tubing will be connected to a pump that will continuously deliver the pain relieving solution. You may also be given stronger pain relievers if needed. Sometimes you can control this pump yourself. This is called patient-controlled epidural anesthesia, but this is only available in very few clinics.
• Combined epidural anesthesia. You will be given a small dose of pain reliever (mini-anesthesia) that works faster than just an epidural. At the same time, the anesthesiologist will insert the catheter but will not administer any medication. When the first pain-relieving injection begins to wear off, the anesthesiologist will begin to inject the pain-relieving solution through the catheter to continue to relieve your pain.

How does it work?

It works in the same way as a local anesthetic. Anesthesia turns off the nerves that transmit pain impulses from the uterus and cervix to the brain.

When should an epidural be given?

Epidural anesthesia can be done in, but most women prefer to do it when the contractions are severe enough, when the cervical dilatation is already 5-6 cm. You may also be offered an epidural, if with oxytocin. This drug increases contractions and causes the cervix to open. You may need additional pain relief, as the administration of oxytocin tends to make your contractions very painful. If you have an epidural catheter placed, it will remain until the end of labor until the placenta separates and leaves. With its help, you can be anesthetized after the birth of the baby, if necessary.

What are the benefits of epidural anesthesia?

• This is usually an effective way to relieve pain during labor.
• It works pretty quickly. It takes 20 minutes to insert the catheter, and anesthesia takes effect 20 minutes after insertion.
• You remain conscious. You understand that you have contractions, but you do not feel pain.
• If you have, an epidural can also be helpful as a blood pressure reliever.
• If you need a caesarean section, the effect of the epidural can be enhanced with a stronger drug.

What are the disadvantages of epidural anesthesia?

• It may happen that it does not work immediately. You may feel that not all areas are numb. If, 30 minutes after the anesthesia is administered, you do not feel that the pain has subsided, you should call the anesthesiologist again.
• You may feel chills due to the epidural.
• With an epidural, you may experience itching or fever.
• You will have to lie down. With a small dose of pain reliever, you may be able to toss and turn in bed, but you certainly won't be able to walk. Although low-dose epidural anesthesia is often referred to as “mobile anesthesia,” few hospitals provide spinal epidural anesthesia.
• To empty bladder, you may need a catheter.
• You will need more attention from the staff. Your child's heartbeat will be monitored closely for at least the first 30 minutes after injection and after each additional dose. Your blood pressure will be measured every five minutes for the first 30 minutes and after each additional dose.
• You are more likely to need to speed up labor with oxytocin. However, maternity staff must provide you with a natural birth before using stimulant medications.
• , the period of pushing may last longer if you have had an epidural. If you don't feel the need to push and your baby's head hasn't erupted yet, you will have to wait at least an hour.
• The risk increases that you will have to use http://www.babycenter.ru/a546719/%D0%B0%D0%BA%D1%83%D1%88%D0%B5%D1%80% to give birth to your child D1% 81% D0% BA% D0% B8% D0% B5-% D1% 89% D0% B8% D0% BF% D1% 86% D1% 8B-% D0% B8-% D0% B2% D0% B0 % D0% BA% D1% 83% D1% 83% D0% BC-% D1% 8D% D0% BA% D1% 81% D1% 82% D1% 80% D0% B0% D0% BA% D1% 86% D0% B8% D1% 8F-% D0% B8% D0% BD% D1% 81% D1% 82% D1% 80% D1% 83% D0% BC% D0% B5% D0% BD% D1% 82% D0 % B0% D0% BB% D1% 8C% D0% BD% D1% 8B% D0% B5-% D0% B2% D0% B0% D0% B3% D0% B8% D0% BD% D0% B0% D0% BB% D1% 8C% D0% BD% D1% 8B% D0% B5-% D1% 80% D0% BE% D0% B4% D1% 8B.
• There is a small chance that you will have a severe headache. This can happen if the epidural needle pierces the sheath of fluid that surrounds the spinal canal and this fluid flows out. The probability of such a case is 1 in 100.
• There is a very small chance of nerve damage, which can lead to numbness in certain areas of the legs or feet, or to a feeling of weakness in the legs. This rarely happens. The probability that a nerve is damaged temporarily is 1 in 1000, and one in 13000 that the consequences of damage will remain forever.

How can epidurals affect my baby?

• Due to epidural anesthesia, your arterial pressure(BP) may drop, which may affect the oxygen supply to your baby. Initially, you will be given an intravenous catheter in case your blood pressure suddenly drops. Blood pressure can be raised with solutions given through a catheter to increase blood volume.
• Epidural solutions contain an opioid analgesic, fentanyl, or a similar drug that can cross the placenta to the fetus. In high doses (over 100 micrograms), these narcotic drugs can interfere with your child's breathing or cause a state of congestion.

• Epidural anesthesia can only be performed under the supervision of an anesthesiologist.
• Not all maternity hospitals that have the ability to give an epidural can count on it at any time. Be prepared for the fact that your maternity hospital does not provide such a service or does, but not around the clock.
• Remain calm and still while the anesthetist inserts the catheter. You will either have to lie on your side or sit on the edge of the bed. You will be asked to lean forward a little to open up the areas between the vertebrae. Monitor your breathing to stay calm. Inhale deeply through your nose and exhale slowly through your mouth.
• Not everyone can get an epidural. Check with your doctor if you have any contraindications.
• If it is important for you to feel like a baby is being born, ask to have the pain reliever weaken before the baby is born. Feeling a contraction can help you push. However, many women find it difficult to endure pain, and early termination of anesthesia does not guarantee that doctors will not use http://www.babycenter.ru/a546719/%D0%B0%D0%BA%D1%83%D1%88%D0 % B5% D1% 80% D1% 81% D0% BA% D0% B8% D0% B5-% D1% 89% D0% B8% D0% BF% D1% 86% D1% 8B-% D0% B8-% D0% B2% D0% B0% D0% BA% D1% 83% D1% 83% D0% BC-% D1% 8D% D0% BA% D1% 81% D1% 82% D1% 80% D0% B0% D0 % BA% D1% 86% D0% B8% D1% 8F-% D0% B8% D0% BD% D1% 81% D1% 82% D1% 80% D1% 83% D0% BC% D0% B5% D0% BD% D1% 82% D0% B0% D0% BB% D1% 8C% D0% BD% D1% 8B% D0% B5-% D0% B2% D0% B0% D0% B3% D0% B8% D0% BD % D0% B0% D0% BB% D1% 8C% D0% BD% D1% 8B% D0% B5-% D1% 80% D0% BE% D0% B4% D1% 8B to reach the baby.

In this article:

Every woman is subconsciously afraid of labor pain. Despite the preparatory stages, prenatal gymnastics and a good emotional mood, the feeling of fear and pain still pursues a woman until the last moment. Very often, acquaintances or girlfriends who like to talk about their childbirth and the consequences after them in paints have a negative effect on the expectant mother. These "horror stories" should be avoided and the slightest fear should be avoided. The calmer the woman in labor, the easier and faster everything goes.

To the aid of modern expectant mothers comes epidural anesthesia during childbirth, which helps to simplify all natural mechanisms of childbirth. With her help, a woman can more easily endure contractions and all labor pains, if all this becomes an unbearable burden for the woman in labor.

What is epidural anesthesia?

Epidural anesthesia is aimed at the action of the spinal region, where special spinal roots with nerve impulses pass. All of them are associated with the pelvic organs, taking into account directly the uterus itself. When an epidural is administered, all of these nerve impulses are blocked and do not transmit pain signals to the brain. Thus, the woman in labor ceases to experience painful sensations or they are felt to a minimum.

Often, such anesthesia is aimed at relieving contractions and giving the woman in labor a break before the birth itself. Doctors are very careful in calculating the dose to be given. This can relieve pain, but not immobilize the person. Women continue to be conscious and active even during childbirth itself.

Epidural anesthesia works mainly during the dilatation of the cervix. Doctors try to carry out efforts and prenatal hours in a natural way, so as not to negatively affect the health of the mother and child.

How is spinal anesthesia different?

Spinal and epidural anesthesia are very similar in their effect on the body, only the spinal anesthesia is injected deeper into the cerebrospinal fluid. This drug is able to act in a completely different way as an anesthetic and naturally the reaction and behavior of a person to pain with it is also different.

Spinal and epidural anesthesia differ only in terms of time frame and a deeper effect on nerve endings. This drug is considered safer and more gentle among doctors.

The prices for these drugs are approximately the same. If a woman gives birth in a regular maternity hospital, then this type of anesthesia should be done free of charge. In a private clinic, such a service may require from 3 to 5 thousand rubles.

How is epidural anesthesia done?

If a woman in labor needs this anesthesia, then she will have to go through a series of small steps to administer the drug. First of all, the woman is placed on her side, her back is slightly bent with the help of the "ball" position and the anesthetic is injected into the spine. Most often, the procedure is performed by several doctors so that the patient does not move once again and does not create additional problems.

Additionally, the site of the future puncture can be anesthetized and must be wiped with alcohol or some other antiseptic drug. To deliver pain reliever gradually, an additional catheter can be inserted into the spine, which can tolerate labor pain throughout the entire process.

If, when the catheter is inserted, the woman begins to experience severe contractions, then it is best to abandon this option and not interfere with the woman in labor to do everything on her own. During the administration of the drug, various negative changes in the body can also occur. Nausea, dizziness, numbness of the body are not excluded. If these symptoms begin, they should be immediately reported to the doctor.

The entire procedure for puncturing the spine and introducing a catheter into the body will take no more than 10 minutes from experienced doctors. Many expectant mothers with trepidation and fear begin to ask questions the day before: "Does it hurt to do epidural anesthesia" or "Does the back hurt after epidural anesthesia?" However, do not worry, the most unpleasant thing is to go through a few not very comfortable seconds during the puncture. All subsequent actions of doctors will simply not be felt by the body. The installed catheter will not interfere with the birth process and will not fall out of the back at the most crucial moment. Often the drug can be administered in different doses and at different time intervals. All this directly depends on the state of the woman in labor and her individual characteristics of the body.

Expectant mothers also should not worry about the entire process of labor with this drug. Nowadays, scientists have proven that such an anesthetic does not have time to penetrate the placenta into the child's blood. Thus, epidural anesthesia has no consequences for the child.

But epidural anesthesia during childbirth will have consequences for the mother herself. A woman cannot fully control her pain and her natural sensations during childbirth. Some doctors treat this drug with suspicion, since the rate of dilatation of the cervix increases significantly, but the attempts themselves become weak and unnatural. Thus, the technique of epidural anesthesia may have little effect on the entire labor process and activity.

Indications and contraindications

The indications and contraindications for this anesthetic can be quite different. It all depends on the course of pregnancy and its complexity. Let's take a closer look at in which cases the drug can have a positive or negative effect on labor and the future health of a woman in labor.

Indications:

1. It can be actively used for premature pregnancy. With the help of the drug, doctors cause active natural relaxation of all the muscles of the pelvis and childbirth takes place in a more gentle and natural environment. Thus, the mother will not experience excessive pain from the fact that her body did not have time to prepare for this process in advance.
2. Improper coordination of labor. In such a case, the woman in labor experiences deep attempts, but the uterus does not begin to contract or does it wrong. In this case, the drug can activate the muscles and help the uterus to open naturally.
3. It is also actively used if a woman in labor has extremely high blood pressure. The drug helps to normalize and maintain pressure at the desired level during all stages of childbirth.
4. Unforeseen complications. Epidural anesthesia is necessary if the fetus is very large or if the pregnancy is multiple. Often, the drug is also used if general anesthesia cannot be used in the expectant mother for some reason.
5. You cannot do without this anesthetic even during very difficult or prolonged labor. For example, Western clinics have been actively using this drug for quite a long time so as not to torture women and create less pain for them. However, our experts have a completely different opinion on this matter.

Epidural anesthesia has quite serious contraindications, which can significantly affect the health or life of a woman in labor.

Contraindications:

1. The drug is unacceptable if the pressure is abnormally low.
2. The woman in labor has any difficulties with the spine, or it is unnaturally curved, which leads to difficulty in inserting the catheter.
3. On the back there is any inflammation at the site of a possible puncture.
4. Allergy or drug intolerance.
5. Heavy bleeding during labor.
6. Mental disorders or unconsciousness of a woman during childbirth.
7. Personal refusal of the woman in labor.
8. Weak blood vessels or heart disease.

Consequences and complications

In order not to deceive women, you need to very clearly explain to them all the risks to which they may be exposed. Such consequences occur quite rarely, but still there is a chance of getting such a problem. Epidural anesthesia first of all gives complications directly during childbirth.

The drug can accidentally enter the veins and spread throughout the body. Then weakness and general malaise is guaranteed to a person. A woman may not possess some limbs, speak poorly, faint, or experience severe dizziness. Most often, if the drug enters a vein, these symptoms occur instantly. If the woman in labor feels them, you need to immediately tell the doctor anesthesiologist about it.

The drug can cause an allergic reaction in some cases. If the doctors did not know in advance the possible reaction of the body to this drug, it is even possible to develop anaphylactic shock. To avoid this, the woman is given a minimal amount of anesthesia to see her body's response.

"What else is dangerous about epidural anesthesia?" - you ask. Difficulty breathing is often possible after using it. Sometimes this is attributed to stress and attempts, but such difficulties are of a slightly different nature. The anesthetic begins to actively affect the nerve endings and muscles that are located between the ribs.

In addition to breathing difficulties, severe head and back pain may develop. Most often, such unpleasant symptoms go away one day after childbirth. But in the most severe cases, this pain can last for several months. In this case, you need to treat it with medication under the supervision of a doctor. Sometimes doctors make a second puncture and do not inject a large number of the patient's blood to "seal" the puncture inside the spine.

All symptoms that relate to dizziness, nausea or weakness also disappear a few days after childbirth. Sometimes, for a quick withdrawal of the anesthetic from the body, the mother is given a cleansing dropper.
I don’t want to scare all expectant mothers who have to undergo this anesthesia, but there is a very small chance of paralysis of the lower extremities.

Unsuccessful anesthesia

In medical practice, there are cases when, after the introduction of epidural anesthesia, the woman in labor does not feel any relief and the painful symptoms do not recede. According to statistics, 5 percent of women in labor do not feel relief after anesthesia, and 15 percent of all women feel only mild relief.

A large number of different factors can be the reason for such unsuccessful pain relief. First of all, it is the individuality of the organism, which reacts to the drug in its own way. Also, anesthesia is often injected in the wrong place due to the inexperience of doctors or through the fault of the woman in labor, if she moved too actively at the same time. The cause of a wrong hit can be, and the excessive obesity of women or a curvature of the spine.

Pros and cons

If expectant mothers no longer have unnecessary questions about the procedure and the effect of the drug on the body, let's more accurately analyze and weigh all the pros and cons of epidural anesthesia.

Positive points:

• the ability to facilitate childbirth, make the process less traumatic and dangerous;
• the opportunity to get some relief and respite for the very process of giving birth to a child;
• the ability to prevent an increase in blood pressure in women.

Minuses:

• various complications of varying severity;
• postpartum complications;
• consequences after epidural anesthesia.

Thus, we really see that epidural anesthesia has its pros and cons. She is able to facilitate the process of childbirth in order to transfer this difficult period in her life to a woman, if the body does not have enough strength and health to do it on its own. Complications after epidural anesthesia can be removed and eliminated from the body as quickly as possible by medical interventions.

The theory of emotional contact with a child

Many people think that giving additional anesthetics is wrong. Many mothers who have successfully overcome childbirth with anesthesia do not believe this theory, however, it has many positive reviews.

During childbirth, mother and baby are exposed to extreme stress. And if the mother is at least in a familiar environment, then the child learns a new world. During this difficult moment in life, both loved ones should be connected with each other and with the common pain that falls on both the mother and the baby. This will allow them to maintain an invisible emotional connection during childbirth. Doctors recommend that mothers tune in for easy childbirth in more other ways and methods, for example, go to special gymnastics, do breathing exercises, learn to relax and establish an internal connection with the baby. Many mothers "negotiate" with the child in advance that everything goes well and without consequences. This attitude makes it easier for mothers to get through all the pains and pains of birth.

In addition, any pain, and even more severe birth pain, produces a huge amount of endorphin hormones, which are responsible for a person's happiness and pleasure. Thus, having gone through everything on her own without anesthesia, a woman can feel unprecedented joy and relief. And if there is no pain, then the woman will not feel joy either.

Each mommy should carefully weigh everything herself before giving birth and set herself up only for a positive result.

Useful video about epidural anesthesia

Many people have to resort to using anesthetics. This is necessary during various surgical operations, as well as when severe pain occurs. There are several ways to anesthetize the human body. This article will discuss how to do epidural anesthesia. You will learn the pros and cons of this procedure, as well as get acquainted with the consequences.

All this information is simply necessary for a person who is about to have any operation or childbirth.

Anesthesia: general description and types

To begin with, it should be said that there are several ways to anesthetize the human body.

Anesthesia can be general. In this case, the patient falls into deep sleep and does not feel what is happening to him. A person regains consciousness only when the doctor finishes all the manipulations.

There is also local anesthesia. It is used for light and rapid surgical interventions with minimal blood loss. During the procedure, the person does not sleep, but his mind is clouded and he does not feel pain. After the procedure, a person can clearly remember everything that happened to him. There are also times when memory is completely missing. It all depends on the dose of the anesthetic and its type.

A more modern method of pain relief is epidural anesthesia. Reviews this procedure has more positive than its predecessors. It is worth talking in more detail about this method of pain relief.

Epidural anesthesia

Reviews of such anesthesia are only positive. When the anesthetic is injected, attention is paid to a specific part of the body. During the operation, the patient is conscious and understands everything.

If general and local anesthesia is administered by injecting a drug into the bloodstream, epidural anesthesia affects the spinal cord. It is worth noting that the introduction of anesthetic should be carried out by a specialist who has experience in this matter.

This type of pain relief can be used for various surgical interventions, but most often it is used during childbirth.

Anesthesia process

Epidural anesthesia reviews are positive only if the anesthesia process was performed correctly. It should be noted that this manipulation is very risky, since the spinal cord is affected.

Before inserting the needle into the back area, the doctor thoroughly disinfects the area. For this, various iodine and alcohol solutions are used. The patient is then asked to sit with her back to the anesthesiologist. The specialist gropes for the area he needs and begins to gradually introduce a long catheter needle. The doctor's goal is to get into the epidural space. Since the anesthetic cannot be injected anywhere, ordinary saline is used to check the correct position of the needle.

A syringe filled with sodium chloride solution is attached to the needle. The anesthesiologist slowly inserts the needle while trying to press the plunger. If the solution meets resistance, then the needle has not yet reached its target. As soon as the medicine begins to freely leave the syringe, the needle is in the epidural space.

At this moment, a catheter is connected to the needle, in which the anesthetic is located. The action of the drug occurs almost at the same second. Nerve impulses in the spinal cord are blocked, and the woman does not feel the lower extremities.

The upper abdomen, arms and head can be anesthetized in a similar way, but this is rarely used. General anesthesia is more commonly chosen when upper body surgery is required.

C-section

It is worth noting that cesarean treatment under epidural anesthesia has only positive reviews. If, when using general anesthesia, a woman does not remember anything, then after the "epidural" she sees the process of giving birth to a baby.

Each woman has the right to independently choose by what method the process of anesthetizing the body will be carried out. If you are scheduled for a cesarean section, epidural anesthesia (reviews of women confirm this repeatedly) is the best option. Ladies note that they like to be conscious during such an important life event. It's also nice that the baby is placed on the mother's chest immediately after it appears. This is how it is customary to do with natural childbirth.

It is worth noting once again that cesarean with epidural anesthesia has only positive reviews. With this method, the woman does not feel the lower abdomen. In the case when general anesthesia is used, many women complain that the anesthesia was not strong enough, and they felt pain during the operation.

After surgery, the catheter can remain in the epidural space for a long time. If there are complications during childbirth by cesarean section, the doctor may allow the woman to be under anesthetics for several more days. This should never be allowed when using general anesthesia.

Vaginal childbirth with epidural anesthesia

This procedure also has only positive reviews. It should be noted that not all women use this method of pain relief. But if you have expressed such a desire during the contractions, then you have no right to refuse.

Also, indications for the use of this pain relief are high blood pressure, young age, multiple pregnancies and a low pain threshold.

During childbirth, epidural anesthesia (reviews indicate this) is not applied immediately. At first, the woman in labor feels all the contractions, and only when the strongest pains begin, an anesthetic is used. If the opening of the cervix occurs rapidly, then the doctor refuses the expectant mother in such anesthesia.

Positive feedback on epidural anesthesia

There are much more good reviews about this procedure than bad ones. If you will soon be using anesthetics, then you need to learn more about the manipulation.

Lack of influence on the child

With general anesthesia of the body, part of the anesthetic enters the child's body through the mother's blood. This is a big disadvantage of this type of anesthesia.

During epidural anesthesia, the drug does not reach the baby, since it enters the mother's body not through the blood, but through the spinal cord. This is a definite plus of this anesthesia.

Loss of sensation and stay of consciousness

Another plus that women in labor are talking about is a complete loss of pain, but at the same time the preservation of consciousness and memory. You can see how your baby is born, hear his first cry. In this case, the lower body will be completely anesthetized.

The ability to establish breastfeeding

If, after general anesthesia, doctors forbid a woman in labor to breastfeed for some time, then with epidural anesthesia it is possible. Due to the fact that the drug does not enter the bloodstream, its effect stops exactly the second when the catheter is removed. Immediately after this, the baby can be applied to your breast.

The only exceptions are those cases when a cesarean section was performed and the patient needs a course of antibiotic therapy.

General positive effect on the body

Besides that given view anesthesia blocks any painful sensations, it also has a beneficial effect on the female body. The anesthetic reduces the level of adrenaline in the blood. The process of childbirth is getting better, the woman in childbirth behaves more calmly and confidently.

Also, a drug that enters the epidural area can slightly reduce pressure. Due to this, the vessels do not expand, but are in a normal state. This is one of the important points why epidurals have good reviews. Varicose veins after childbirth with a normal state of blood vessels is unlikely. The same cannot be said for delivery, which takes place without any pain relief.

Complications of anesthesia and consequences

Complications of epidural anesthesia are not very common, but they do occur. That is why, agreeing to such anesthesia, you need to know all its disadvantages. The consequences of epidural anesthesia during childbirth can be very different. Some of them are completely invisible and do not affect the quality of life in any way, while others are very dangerous.

Disability

The worst consequences after epidural anesthesia are damage to the spinal cord and all nerve endings. This phenomenon occurs extremely rarely, but no one is immune from it. You do not know how the spinal roots can be affected by the action of this or that anesthetic. Perhaps the blockage of pain will occur for the rest of your life, and you will never be able to feel your lower body again. In this case, the person remains disabled.

Headache

Headaches after epidural anesthesia are common. They arise due to the fact that during a puncture, the needle damages the vesicle with cerebrospinal fluid. Some of this compound leaks out and causes pain in the head.

Similar impulses can occur due to the use of an unsuitable anesthetic. Such complications of epidural anesthesia disappear within one month, and the woman happily forgets about them.

Backache

Epidural anesthesia during childbirth can have consequences in the form of discomfort in the back. If the puncture was initially made incorrectly, or the substance was injected in the wrong place, then later the woman may feel pain in the back.

These sensations are very different from muscle pain. They are more like the so-called lumbago. If a woman turns to doctors with such complaints, she is prescribed to take painkillers, which are allowed for breastfeeding... Back pain after epidural anesthesia disappears within one to two weeks.

Lowering blood pressure during childbirth

Epidural anesthesia (doctors' reviews in this sense are unanimous) can greatly reduce the blood pressure of a woman in labor. If it becomes very low, then the expectant mother will not be able to give birth on her own. She simply does not have enough strength during the attempts.

That is why, during natural childbirth, doctors use a small amount of anesthetic and inject it temporarily.

Prolongation of labor

What are the consequences of epidural anesthesia?

Many patients, during preparation for planned operations, are interested in what the consequences of epidural anesthesia may be during childbirth. After all, this method of pain relief is still little known to ordinary people.

The epidural space in humans is located along the spinal column. It envelops the hard protective sheath of the nerve roots and directly the spinal cord itself.

Epidural (epidural) anesthesia helps to block the transmission of nerve impulses at the location of the nerve roots. As a result, a decrease in intensity or complete suppression of pain is achieved. An anesthetic is injected directly into the epidural area (space) using a specially designed catheter.

This kind of anesthesia is performed by administering various pain medications. This allows the procedure to be performed with varying degrees of effect.

Analgesia leads to loss of pain. Anesthesia is necessary for complete loss of sensation. Muscle relaxation is performed to relax muscle tissue and reduce pain.

Indications for epidural anesthesia during childbirth

Epidural anesthesia is a medical procedure that presents a certain degree of risk to the patient. Peridural anesthesia can provoke side effects, has contraindications and is fraught with negative consequences. Only an experienced specialist should administer the drug.

A complete examination of the patient, a thorough examination of the anamnesis and the results of laboratory tests are carried out beforehand. Based on the data obtained, the anesthesiologist and the specialist who carry out the main treatment of the patient make a decision on the admissibility of carrying out in a particular case.

Carrying out such anesthesia is sometimes prescribed during obstetrics (especially when caesarean section), during urological and gynecological operations. Spinal anesthesia is also used for surgical intervention in the lower extremities, perineum, and pelvic organs.

The drugs used

It involves the use of various drugs to achieve the desired effect. All injected solutions undergo intensive cleansing and are freed from preservatives. This increases their effectiveness and safety for the patient.

The main drugs for epidural anesthesia are local anesthetics:

• bupivacaine;
• lidocaine;
• ropivacaine.

To intensify the analgesic effect, opiates are additionally used:

• buprenorphine;
• morphine;
• promedol;
• fentanyl.

In special cases, medications such as the following are added to the epidural solution:

• clonidine;
• ketamine;
• physostigmine.

The specific composition of the injected solution is determined strictly individually. Its dosage is selected at the rate of 1 or 2 ml of liquid for a separate segment of the spinal cord that needs to be blocked. The defining moments are the clinical picture and the state of health of the patient.

Contraindications to the procedure

The main contraindications for the use of epidural anesthesia are:

Possible consequences

Spinal epidural anesthesia has various consequences that are dangerous to the patient's body. Some of them can be predicted in advance. Then it is better to refuse this type of anesthesia. Some complications arise unexpectedly and for no apparent reason.

The degree of danger in a particular case is determined by such factors as:

• the age and general condition of the patient;
• the composition of the anesthetic solution;
• correct procedure.

The main negative consequences of such anesthesia are:

Some of the consequences gradually disappear with the postoperative resuscitation of the body. Dangerous complications require special treatment.

Epidural anesthesia for caesarean section

Such anesthesia is increasingly used in obstetrics, relieving a young mother of the pain caused by the birth of a child. for a planned or emergency caesarean section, it is preferable to general anesthesia. The woman in labor remains fully conscious.

She can see her baby immediately after birth, hear his first cry. Therefore, many expectant mothers who are prescribed to give birth by caesarean section are asked to replace general anesthesia with epidural anesthesia.

The final decision is made, of course, by specialists: obstetricians, anesthesiologists, pediatricians. After all, complications after epidural anesthesia are possible not only in a woman in labor, but also in a baby.

Consequences of epidural anesthesia during childbirth

If the required dose of anesthetic is exceeded, a woman in labor may experience:

• toxic effects on the brain;
• a sharp decrease in blood pressure;
• the development of convulsive syndrome;
• violation of the respiratory process;
• heart failure.

If the specialist injecting the anesthetic is not sufficiently qualified, the needle or catheter used during the procedure can injure the roots of the nerve endings of the spinal cord. Failure to comply with the required level of sterility around the injection site begins infection and inflammation. Very often, in a similar situation, septic meningitis begins.

A sharp drop in blood pressure causes general weakness, nausea, vomiting. In this case, to stabilize the condition, it is enough to correct the pressure with the help of special drugs.
In case of an error in the administration of the anesthetic, a puncture of the hard membrane of the spinal cord is possible. This causes severe post-dural puncture headaches and general weakness. Therefore, bed rest and absolute rest are prescribed, at least for a day.

When a significant dose of anesthetic solution enters the blood vessel, severe intrasystemic intoxication occurs. Injury to the roots of the spinal cord leads to the development of severe pain in the back and in the spine. In this case, limitation of physical activity is also possible.

Epidural anesthesia during childbirth - consequences for the baby

The results of special studies do not yet allow us to give an unambiguous answer to the question of the danger of the effect of epidural anesthesia for a child. The main factors that can cause negative consequences are:

It is reliably known that an epidural anesthetic administered to a young mother during natural childbirth significantly reduces the activity of the child. This complicates its birth, reduces the rate of passage of the fetus through the birth canal. In this case, it becomes necessary to use vacuum extraction, forceps and other methods of assistance during childbirth. This can cause serious injury to the newborn.

If, after the injection of the anesthetic solution, the woman begins to tremble, the child experiences a significant lack of oxygen. In the future, the dangerous consequences of epidural anesthesia lead to all sorts of problems with breastfeeding.

Complications of epidural pain relief during abdominal operations

The use of epidural anesthesia during surgery is carried out for partial anesthesia of certain areas of the patient's body, in addition to general anesthesia and for relief of postoperative pain syndrome. Anesthetics, opiotics and other drugs used for anesthesia can have side effects on the patient's body. Specific complications in this case depend on the dosage violation, improper procedure, individual characteristics of the state of health.

Many complications following epidural pain relief resolve over time without treatment or are easily treated with medication. These include:

• shiver;
• itching and chills all over the body;
• drop in blood pressure;
• partial or complete immobility;
• back pain;
• partial numbness or loss of sensation in case of damage to the nerve fibers.

Serious problems are created by a break in the catheter through which the anesthetic is injected. In this case, it is necessary to carry out a special surgical intervention to remove the broken end that is stuck in the spinal canal.

An error in the introduction of an epidural injection, leading to injury to the bone, subsequently causes severe pain in the spine and back. To eliminate them, a special course of treatment is required.

Headaches after using epidural anesthesia can have different intensity thresholds. If they arise as side effect the injected anesthetic, then they are easy to stop. Over time, the syndrome disappears. In the case when the epidural needle pierces the hard spinal cord, in order to relieve the patient of headaches, the puncture has to be repeated. When the accidental puncture is blocked, the pain will gradually subside.

The resulting cramps and difficulties in the administration of natural needs (especially when urinating) will help to eliminate the intake of appropriate medications. Additionally, a course of physiotherapy and other healing procedures is prescribed.

Today, almost every maternity hospital offers a pregnant woman an epidural during childbirth. She injects the woman in labor in the back at a certain stage of the birth process, relieves pain and eases the condition of the expectant mother. However, this procedure may not be permissible for everyone. There is a certain category of women for whom spinal anesthesia is contraindicated. In this article, we will talk in detail about what epidural anesthesia is, how it is performed and why it is dangerous.

Epidural anesthesia is a kind of local anesthesia. It relieves pain in contractions, which are sometimes simply unbearable for a woman.

Anesthesia is injected into the lumbar spine, where the epidural space is located. It contains the spinal roots of the nerve endings of the pelvic organs, which include the uterus. Anesthesia blocks pain, and a woman may not feel any unpleasant symptoms for a long period of labor. In this matter, you need to choose the right dosage for the woman in labor so that she does not feel painful contractions, but at the same time she can walk on her own and be conscious. By the way, today epidural anesthesia is widely used for caesarean section, which allows mothers to see the birth of their child, even if she cannot give birth naturally.

It should be noted that in natural childbirth, the effect of epidural anesthesia continues only during the period of labor, when the cervix opens up so that the child can pass through the birth canal. The woman is forced to endure the attempts without anesthesia, but they do not last long, so you can endure them.

If a woman needs to apply epidural anesthesia purely for medical reasons, then she is given it free of charge, but if she herself simply expresses a desire to give birth under anesthesia, then she will have to pay for it separately.

How is epidural anesthesia done?

The technique of epidural anesthesia is quite complicated, although it takes only 10 minutes to administer spinal anesthesia. It requires a highly qualified anesthesiologist and adherence to strict rules:

1. A pregnant woman should head over her back, sit bent over, or lie on her side so that the doctor has access to the puncture site. It is very important to freeze in the chosen position, because excess body movements can lead to many complications.
2. The doctor treats the area to be pierced with a special antiseptic.
3. The anesthesiologist will then numb the area to be pierced. For this, the banal Lidokoin is used.
4. After that, a special set for epidural anesthesia is used - a special needle with anesthesia is inserted (it will work 20 minutes after injection). It should reach the dura mater. A special tube is inserted into the needle - a catheter, which will be in the back of the woman in labor until the very attempts. Just keep in mind that anesthesia cannot be administered at the time of a contraction. If you feel that the contraction is approaching, then inform the doctor, because at the time of the spasm, you can move, and this will lead to disastrous consequences.
5. After giving birth, the catheter is removed from the woman's back, but for 2-3 hours after the epidural anesthesia, the doctor will recommend that the woman in labor remain stationary.

Epidural anesthesia during childbirth can be administered to a woman in two ways:

1. Step by step, introducing small doses.
2. Once, by introducing the entire dose of the drug at once. With this method, a woman cannot get up, because the components of anesthesia will dilate the vessels of the legs, the woman in labor will simply not be able to walk.

Epidural anesthesia is absolutely safe for the child. Painkillers do not enter his bloodstream, because the placenta does not absorb them.

Indications for epidural anesthesia in the hospital

Western medicine practices epiduarial anesthesia all the time. Women, as soon as she comes to negotiate the birth, are immediately offered to use local anesthesia. Domestic medicine recommends the use of spinal anesthesia only for strict medical reasons:

• If a woman started premature birth... A premature baby with a relaxed cervix under the influence of anesthesia will find it easier to pass through the birth canal.
• If a woman's labor activity is so weak that there are contractions, but there is no disclosure.
• If the woman in labor has too high blood pressure, at which the woman cannot give birth herself. Epidural anesthesia, according to reviews, perfectly reduces pressure.
• If a woman has a multiple pregnancy or her baby is too large, as a result of which she cannot give birth herself, and general anesthesia is contraindicated, spinal anesthesia is suggested.
• If childbirth is delayed, and the pregnant woman can no longer tolerate labor pains, then she is given anesthesia.

Contraindications to epidural anesthesia

• vegetative-vascular dystonia in a pregnant woman;
• deformed spine, which complicates the puncture process;
• there are rashes on the skin in the area where the puncture will be carried out;
• blood problems (poor clotting, infection);
• bleeding;
• individual intolerance to the components of anesthesia;
• the woman is unconscious;
• heart or vascular disease;
• do not give epidural anesthesia for a hernia of the lumbar spine.

Complications of epidural anesthesia

After an epidural, a woman may experience some complications:

1. The doctor may accidentally get into the venous bed of the spine, and then the woman will start having headaches after the introduction of epidural anesthesia, she will feel nauseous, and her tongue will become numb.
2. Anaphylactic shock can occur (this happens if a woman does not know that she is allergic).
3. Quite rarely, there is such a consequence of epidural anesthesia as shortness of breath.
4. In addition, women in labor often complain of back pain after epidural anesthesia. The back may hurt for several days after giving birth. If the pain after epidural anesthesia does not stop, then doctors should make a puncture again in the place where the anesthesia was injected in order to inject the woman's blood there, which will fill the puncture site.
5. After epidural anesthesia, the legs can be taken away, but this only happens if the anesthesia technology has been incorrectly carried out.
6. After giving birth with an epidural, a woman may have difficulty urinating.

To avoid the negative effects of an epidural, you need to weigh the pros and cons of this procedure. We will tell you more about this later.

Epidural Anesthesia: Cons and Pros

Some of the main benefits of spinal anesthesia during childbirth include:

• the ability to make childbirth painless and comfortable;
• if childbirth is delayed, then the woman may even sleep after epidural anesthesia;
• Women in labor with high blood pressure using spinal anesthesia may not be afraid to give birth on their own.

The main disadvantages of epidural anesthesia are:

• some complications may occur due to the incompetence of the doctor or the sudden movement of the woman during the puncture;
• a mother can lose a psycho-emotional connection with a child, although this fact has not been proven.

Your main goal is to listen carefully to your doctor about what to do after your epidural. Compliance with the doctor's recommendations will help prevent possible complications and properly recover from spinal anesthesia.

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