What are the risks of epidural anesthesia? Complications after epidural anesthesia during childbirth for mother and child. Is epidural anesthesia harmful for a child?

Epidural anesthesia is the process of inserting a needle into the area around the spinal cord. Medicine is passed through the catheter, which blocks the tingling impulses in the lower torso, making it so that the woman does not feel anything. Many pregnant girls decide on such a manipulation, referring to the fact that everything will pass without problems and quickly.

There are a lot of reviews of people who have experienced this on themselves: some are delighted with the manipulation, others are trying to forget about such an experience, like a nightmare.

Conduct epidural anesthesia for childbirth it is possible if there are no contraindications and complications or when other pain medications do not help properly. She is appointed without fail if there is one or more of the following factors:

Underage mother.
Premature contractions.
The woman is expecting twins.
A caesarean section is expected.
There are anomalies.
Pronounced threshold of sensitivity.
High blood pressure or vasospasm.
Hypertension.
Stimulation needed.

How is the procedure

First, the lower back is smeared with a special antiseptic solution to remove all bacteria and microbes.
A needle is inserted into the place chosen by the doctor. A catheter is inserted into the needle and an anesthetic is delivered through it.
The procedure is fast and efficient: 5-10 minutes.
The effect of the anesthetic does not come immediately, you have to endure 15-20 minutes.
Over time, the introduction of the drug, there is numbness of the legs, weakening of contractions, tingling in the limbs.
Mom does not feel pain at all, she only feels the contraction of the uterus.
If there is a need for rest, mommy is allowed to rest and gain strength, even get some sleep.
At the end of the drug, sensations return to normal.
If the effect subsides, the dose is increased and a certain amount of the substance is administered.

When a woman in labor has no contraindications or recommendations for manipulation, but only her own desire, it is worth thinking carefully, weighing all the pros and cons.

Contraindications

It depends only on the decision of the doctor whether this manipulation will be carried out. Even with the strong desire of the mother and unbearable pain, there may be good reasons for refusal.

Cases and reasons in which it is absolutely impossible to carry out the procedure:

Increased intracranial pressure.
Infections at the injection site.
Heart defects.
Poor blood clotting.
Sepsis, pyelonephritis, chorioamnionitis.
The presence of bacteria in the blood.
Bleeding.

Use with caution if:

Increased body temperature.
There is neuroscience.
There is a scar in the uterus.
There are no fights.
The cervix is dilated more than 7 cm.

This method of anesthesia should be used very carefully if the patient suffers from epilepsy or diabetes mellitus.

Pros and cons of childbirth

If the decision was made in the direction of manipulation, the mother experiences a number of advantages:

Reducing discomfort.
Decreased feelings of anxiety.
Reducing the level of the "stress hormone" - catecholamine.
The state becomes calm and favorable for the birth of a baby.
Eliminates the risk of high blood pressure for those who suffer from hypertension.
The girl is able to rest or even sleep if she is very tired and the process lasts for quite a long time.

The pressure may drop too abruptly in those suffering from hypertension.
Childbirth differs in duration.
The analgesic effect of the procedure may be minimal or completely absent.
Possible increase in body temperature.
back pain after injections.

Cons after childbirth

Even if successful consequences of epidural anesthesia on the course of childbirth, the woman in labor and the condition of the child are very strong. Possible:

Difficulties in breastfeeding.
Headache.
Violation of the fetal heartbeat.
The risk of bleeding increases.
There may be frequent urinary incontinence.
Aching and discomfort in the lumbar region.
Pain after epidural anesthesia back after minor physical exertion.
Certain areas of the entire body may experience tingling and numbness.
There may be ringing in the ears and a violation of the sensitivity of the skin.
The emotional and psychological connection between mother and child, inherent in nature, is lost, which can lead to indifference towards the baby.

Children born through this procedure are more lethargic and weakened, their activity is significantly reduced, they are more likely to develop infections. Such a child may cry a lot, be apathetic and even not want to eat.

The likelihood of complications

Complications after epidural anesthesia are too rare to pay close attention to. But to study real cases, it is still worth it.

The anesthetic will enter the vein. The woman feels weakness, nausea, dizziness, numbness of the tongue and a specific taste in the mouth.
Allergic reactions appear. The chance of encountering an allergy increases if a woman has not previously encountered painkillers. A strong reaction causes anaphylactic shock, swelling and suffocation. To exclude this, it is necessary to conduct tests on the product.
Labored breathing. It rarely occurs as a result of a specific effect on the nerves.
Pain in the back and head. Unpleasant symptoms may disappear within a day or last for several months. It is easy to fix the problem with the help of drugs or in a radical way, when a little of the woman’s own blood is injected into the anesthetic puncture site. At the same time, unpleasant symptoms are blocked.
There is a feeling of dizziness, ripples in the eyes, bouts of nausea or even vomiting. To avoid such a symptom, bed rest and a dropper are recommended after the procedure.
Paralysis of the legs. The most destructive complication after epidural anesthesia after childbirth.

In some cases, the procedure may not give the desired effect: it may not work at all or only partially. The doctor is not always able to get into the right area. The reason may be inexperience, overweight of the patient, or if the spinal column has violations in its structure. By increasing the concentration of the product or the number of punctures, the anesthesiologist is able to eliminate the problem.

Conclusion

Having a number of positive points, epidural anesthesia after childbirth cause unexpected consequences for both the mother and her baby. Relieving pain for yourself, there is a chance of harming the baby. The pain that a woman in labor and a baby experience together forever connects them, establishing a strong bond for life.

If there are no symptoms other than fear, it is recommended to attend courses for pregnant women, study breathing techniques, read special literature, engage in light sports, stretch muscles. It is useful to walk and move a lot, eat fruits and vegetables, drink citrus juices and clean water: this will save you from excess weight and troubles in the future. The correct lifestyle of the mother leads to the normal weight of her crumbs and easy childbirth.

Hello friends! This is Lena Zhabinskaya! A few years ago, future mothers began to actively discuss the epidural, and that is what they call epidural anesthesia in their circles. A miraculous injection into the spine literally “turns off” all sensations below the waist, allowing the woman in labor to give birth to a baby painlessly.

Initially, there were a lot of rave reviews around him, but over time they calmed down. The reason for this is the harm that this method of anesthesia can bring. How big is it and how dangerous is it? We will talk about this. So, epidural anesthesia during childbirth: consequences.

An epidural is a type of local anesthesia that involves injecting medication into the spine at the level of the lower back. It is resorted to during natural childbirth, and during surgical operations, including laparoscopic, and with caesarean section.

The need for its use is explained by the mechanism of action. Judge for yourself: the internal organs and the spinal cord are interconnected by nerves that resemble roots. It is these nerves that send signals from the brain that are responsible for the mobility, contraction or sensitivity of the muscles. The area in which all these nerves are massively concentrated is called the epidural space.

Therefore, it is quite natural that such anesthesia involves the introduction of drugs into this area that block pain impulses sent by the pelvic organs to the brain. As a result, the woman in labor remains conscious, can walk and move, but she does not feel the pain of contractions.

The only thing that can alert a woman is how epidural anesthesia is done. This is a more complex procedure than standard intravenous anesthesia. During it:

First time trial. The anesthetist administers a test dose of the drug to make sure it works for the woman. If all is well, repeated doses are given at regular intervals.

It takes about half an hour from the start of the procedure until the moment of anesthesia. It takes about 10 minutes to place the catheter, another 20 minutes are allotted for the effect of the drug.

When is epidural anesthesia given? As a rule, in the first birth period, that is, at the time of contractions. When the cervix is fully dilated, the administration of the anesthetic is stopped. Otherwise, the woman in labor will not be able to feel the strength and duration of contractions at the stage of attempts.

Anesthesia can be resumed in case of ruptures and incisions, when the damaged tissues are sutured again.

Note! Despite the fact that the usual anesthetics are used for epidural anesthesia during childbirth, for example: lidocaine, novocaine, bupivacaine, the occurrence of nausea, dizziness, numbness of the tongue and extremities is not uncommon. All of them are adverse effects that should be reported to the doctor.

An epidural is done both in the second birth and in subsequent ones.

How is it different from other types of anesthesia?

When asked if an epidural is needed, doctors answer positively if the woman in labor cannot give birth without anesthesia. Simply because its essence is reduced to a decrease in the sensitivity of the body or certain parts of it. Under normal conditions, this can be done with the help of general anesthesia or intravenous. Meanwhile, these methods make it impossible for the hard period and the participation of the woman herself in it.

Another thing is epidural anesthesia. It is designed specifically for the mother who needs to reduce pain sensitivity, but maintain muscle contractions. In other words, she needs to remain conscious and able to move, actively participate in childbirth.

Young mothers often confuse spinal and epidural anesthesia, because both of them are designed for the back, that is, they are inserted into the dorsal spine. However, they still have key differences:

Indications and contraindications

In addition to the desire of a woman to help herself during labor, there are cases when an epidural is necessary. Indications for its use:

surgery and the impossibility of using other types of anesthesia;
violations of labor activity, which are expressed in the wrong contraction of the uterus;
hypertension;
soreness and duration of contractions, as a result of which the woman in labor runs the risk of being exhausted at the stage of attempts;
low pain threshold (but here the doctors' opinions about the need for anesthesia are ambiguous);
preterm labor and the need to stimulate the opening of the cervix.

Contraindications:

excess weight, due to which the ability to get into the desired section of the spine is reduced to zero;
individual intolerance to anesthetics;
high body temperature;
high intracranial pressure;
hypotension;
blood diseases or disorders of its coagulability;
diseases of the cardiovascular system;
risk of bleeding during childbirth;
pathology of the spinal cord and brain;
violations of the integrity of the skin at the puncture site, including tattoos.

Such anesthesia is not performed if the woman is unconscious. In addition, there may be other reasons why the doctor will refuse to set it up.

How long does the anesthetic last? How much is needed, because if necessary, the medicine is administered repeatedly through the catheter. How long does it take to get off the epidural? If everything is fine - a few hours, if there are complications, then a few years.

Consequences and complications for mother and child

Like any drug, medications that are administered during epidural anesthesia affect the body. The degree of this influence directly depends on the state of health of the woman before and after childbirth.

The most common adverse reaction is allergy. It does not matter the price of the drug used, if there is its individual intolerance. The only way doctors can protect a woman in labor is to give her an initial trial dose, which minimizes the development of anaphylactic shock.

What other consequences could there be? Back pain or headaches that do not go away within a few months of delivery. They arise due to the ingress of cerebrospinal fluid into the epidural space and disappear only after taking medication.

Other cons of an epidural:

weakness;
nausea;
numbness of the tongue;
dizziness;
the appearance of an unusual taste in the mouth.

As a rule, they appear immediately after anesthesia and indicate the need to cancel the anesthetic.

There are also complications. For example, at the time of administration of an anesthetic, a woman's blood pressure may drop. Then she is advised to just lie down for a bit. The most terrible physiological consequence is paralysis of the lower extremities. It can occur regardless of whether epidural anesthesia was paid or not. Most often, it develops as a result of compression of the brain due to bleeding in the epidural space.

Another factor that makes women think about whether to do an epidural is the psychological consequences. There is an opinion that any intervention in the natural process of childbirth can lead to a loss of emotional connection between mother and baby and further depression in a woman. Just because they did not pass the test of pain and did not become closer.

As for my personal experience, I gave birth to both of my children (by the way, weighing 4240 g and 4260 g) on my own without anesthesia. But not because I didn’t want to put it on, but because in my maternity hospital they didn’t put it (even for a fee) without strict testimony. In my opinion, childbirth is a real hellish test for a woman. Despite all the talk that it is natural and so conceived by nature itself, labor pains are beyond reason, beyond good and evil. Thanks also to my husband for, if not for him, I don’t know at all how I would have survived them.

And in those moments when I practically lost consciousness from hellish fights, I did not understand what all this was for. Moreover, the second birth was longer, more painful and (according to my feelings), more difficult than. Whether or not to put anesthesia - this should be a personal conscious decision of each expectant mother. In no case do I call anyone for anything, but as for me personally, at this stage I have an understanding that during the next birth (if any), I will put epidural anesthesia and will certainly take care of this issue in advance before delivery .

For a child, such anesthesia is practically safe, because the doses of the drugs are minimal, and it is administered locally. But perhaps the harm from it has simply not yet been identified.

medical errors

Why is an epidural dangerous? A non-professional can make a puncture in the wrong place, damage tissues, ligaments, blood vessels, and even a hernia that the patient has. The result is constant back pain.

Another option is the wrong dose of anesthetic, which becomes toxic and reduces its effectiveness. Due to the hit of the painkiller in the brain, spasms and unconsciousness appear. When the nerves are damaged, the legs go numb, sometimes for life, and these are not empty words, but reviews of women in labor.

What is the price

How much does anesthesia cost? This is decided by the administration of the maternity hospital based on the patient's health status. Its usual cost is 3-5 thousand rubles. Meanwhile, it is paid only in the absence of indications for it, that is, when the woman herself asks to anesthetize the process.

According to indications, the epidural is placed free of charge.

Do?

Should I do an epidural? Everyone must decide for himself, weighing all the pros and cons. It is unlikely to bring harm to the child in the future, but it can affect the life of a woman. There is a different look at this problem in the video. Look, draw conclusions and make the right decision.

Epidural anesthesia is one of the ways to alleviate the condition of a woman during childbirth. This process frightens many women with its pain, but modern medicine offers several methods to eliminate this phenomenon.

What is epidural anesthesia?

In the lumbar spine, in the epidural space, the spinal roots exit through which the transmission of nerve impulses from the pelvic organs, including the uterus, occurs.

An injection of special drugs blocks these impulses, as a result of which the woman stops feeling contractions. The anesthesiologist calculates the dose so that sensitivity below the waist disappears, but at the same time the woman can move independently and is conscious.

The action of anesthetics applies only to contractions, that is, to the period of cervical dilatation. Further attempts and the passage of the baby through the birth canal are not anesthetized.

Difference between spinal procedure and epidural anesthesia

Very often these two events are confused. Indeed, at first glance, they are no different. But when performing spinal anesthesia, a thinner needle is used and the active substance is injected into the cerebrospinal fluid slightly below the level of the spinal cord. As a result, the drugs work a little differently than with epidural anesthesia.

It is worth noting that the latter is safer in terms of possible complications.

Features of the procedure

The procedure consists of the following steps:

The woman sits with her back bent or lies on her side, curling up. The posture should provide maximum access to the spine. It is important not to move during the puncture and be prepared for it. At this point, there will be a slight discomfort, but you can not move away from the doctor. If a woman does not move, she will thereby reduce the risk of complications;
The area where the puncture is supposed to be made is treated with an antiseptic;
Then an anesthetic is injected to eliminate the sensitivity of the skin and subcutaneous fat;
After that, the anesthesiologist makes the puncture itself and inserts the needle to the meninges;
A thin silicone tube is passed through the needle - a catheter. It is through it that anesthetics will enter the epidural space. The catheter is left in the back for the required time. It is not removed during childbirth. When it is entered, a “lumbago” may occur in the leg or back, which occurs due to touching the nerve root with a tube;
After the catheter is inserted, the needle is removed, and the tube is fixed on the back with adhesive tape;
Then the minimum dose of the drug is administered to check the adequacy of the body's reaction (no allergy);
After the baby is born, the catheter is removed, and the puncture is again sealed with adhesive tape. The woman will have to lie down a little more so that there are no complications.

Painkillers can be administered in two ways: continuously, that is, at regular intervals, but in minimal doses; once, repeating after 2 hours, if necessary.

Unlike the first option, when you can walk after a few minutes, in the second case, the woman must take a supine position, because the vessels of the legs expand and the outflow of blood can lead to loss of consciousness when standing up.

Anesthesia is carried out with the use of Lidocaine, Novocaine or Bupivacaine. They do not cross the placental barrier.

Preparation, contraindications and indications for the procedure

Epidural Anesthesia Kit includes:

epidural needle and corresponding catheter;
disposable syringes;
bacterial filter;
a special device for injecting anesthetic from a syringe into a catheter.

If during the procedure there are unpleasant sensations, for example, legs or tongue become numb, you begin to feel sick, then you must definitely inform your anesthesiologist about this, because such phenomena should not happen. When a woman feels that a fight is about to begin, she should also warn a specialist. He will stop and wait until it ends.

The process itself takes no more than 10 minutes. Anesthetics will begin to work after another 20 minutes. One of the points of interest is the pain of the procedure. It is worth noting that it causes only slight discomfort, which can be tolerated, because they last only a few seconds. The catheter also does not cause discomfort, even when moving.

Indications for anesthesia:

premature pregnancy;
anomalies of labor activity;
increased blood pressure;
impossibility of general anesthesia;
the process of childbirth continues for a long time;
the need for surgical intervention.

Among the contraindications are the following:

increased cranial or low blood pressure;
deformity of the spine, making it difficult to access the catheter;
inflammation in the area of the proposed puncture;
bleeding disorder or infection;
reduced number of platelets;
individual intolerance;
unconscious state of the mother;
psychoneurological disorders;
a number of diseases of the cardiovascular system and the refusal of anesthesia.

Consequences and complications of epidural anesthesia after childbirth

Entry of drugs into the blood. There are many veins in the epidural space, so there is an increased risk of anesthetics entering the bloodstream. When this happens, the woman feels nausea, dizziness, weakness, a strange taste in her mouth, and numbness of the tongue occurs. When such conditions appear, you need to urgently consult a doctor, since they should not be;
Allergy. It is quite possible that after the introduction of an anesthetic, anaphylactic shock will occur, that is, a malfunction in the functioning of the vital systems of the body will occur. This can happen if a woman in labor has never come across such substances in her life and is not aware of her negative reaction to them. To exclude such consequences, at first the doctor injects the minimum dose and carefully monitors the condition of the woman;
Difficulty breathing. A rather rare side effect that occurs due to the action of an anesthetic drug on the nerves leading to the intercostal muscles;
Back pain. The most common gutter after such a procedure. Soreness occurs as a result of a puncture of the meninges and entry into the epidural space of a small amount of cerebrospinal fluid. Usually the pain disappears after a day, but many patients claim that they can be observed for several more months;
Headache. They occur for the same reason as back pain. To eliminate these two unpleasant effects, medications are used or the puncture is repeated, followed by the introduction of the woman's own blood, which will block the puncture;
Lowering blood pressure. There may be “flies” before the eyes, nausea and even vomiting may suddenly begin. To prevent such effects, put droppers. After performing anesthesia, the woman in labor should not get up during the time set by the doctor;
In some cases, there are difficulties urinating;
The most dangerous complication is paralysis of the lower extremities. This is a rather rare situation, but still you should not exclude it from possible risks.

In about 20% of cases, pain relief does not occur at all or is observed, but partially. Such moments are explained by several factors. For example, when carrying out the procedure by an inexperienced specialist, although often beginners are not allowed to perform such manipulations, with obesity in a lady and anomalies of the spine.

Childbirth is always accompanied by pain, the strength of which depends on individual indicators. In cases of severe pain and a number of other indications, a woman may be asked to do epidural anesthesia. We will talk about what it is and what it can threaten the mother and child with.

Epidural anesthesia - type local anesthesia, which involves the introduction of a drug into the spine. This area is located in the lumbar region and is called epidural space.

This type of anesthesia is used during natural childbirth as well as caesarean sections.

For epidural anesthesia, such familiar painkillers are used: novocaine, lidocaine, ropivacaine, bupivacaine.

What is the difference from spinal anesthesia

Parturient women often experience confusion about choice between epidural and spinal anesthesia because the procedures are very similar. However, these methods have the following key differences:

Anesthetics are injected into the spine, but in different parts of it. In one case, this is the subarachnoid space (fluid surrounding the spinal cord), and in the other, the epidural (fatty tissue of the spine preceding the subarachnoid part).
Due to the fact that the drugs are injected into different parts of the spine, they also have different effects. With the spinal method, the spinal cord is blocked, and with the epidural method, parts of the nerves are blocked.
The speed of anesthesia differs: spinal anesthesia - 5-10 minutes, epidural - 20-30 minutes.

The procedure for administering an anesthetic is as follows:

The woman lies on her side, curled up, or sits down with her back slightly bent forward. In this position, the patient must freeze and not move during the entire procedure. The accuracy of the work of the anesthesiologist and the likelihood of adverse consequences will depend on this.
The doctor treats the puncture area with an antiseptic.
A regular injection of pain medication is given into the lumbar region to relieve sensitivity at the site that will be pierced.
The doctor makes a puncture with a special needle. At this point, the patient should not experience numbness of the limbs, tongue, dizziness, or nausea. If these symptoms occur, you should immediately tell the anesthesiologist about them.
A catheter (silicone tube) is passed along the needle, through which an anesthetic is injected.
The needle is removed, and the catheter is attached to the back with a band-aid and removed until the end of labor.

First, a small amount of anesthetic is given to check for possible adverse reactions in the body. After the birth is over and the catheter is removed, it is recommended to remain in a supine position for several hours. The entire catheter insertion procedure takes approximately 10 minutes.

Anesthetics cannot cross the placenta, so do not affect the fetus. However, the composition of the medicine includes narcotic substances that penetrate through the blood to the child and can harm him. Many doctors are inclined to believe that exposure to these substances is insignificant and does not entail serious consequences.

The epidural has an insignificant effect on the process of childbirth, which boils down to the fact that relaxes the cervix thereby facilitating and speeding up childbirth. Often the procedure is prescribed for those women who have a mismatch in labor, that is, asynchronous contraction of the muscles of the uterus. In this case, anesthesia helps streamline the process of childbirth.

Indications for use

A woman can ask for an anesthetic procedure herself. But there are certain medical indications when epidural anesthesia is recommended by a doctor:

Premature birth (term - up to 37 weeks). Anesthesia relaxes the muscles of the pelvic floor, and the premature baby experiences less overload, softer passing through the birth canal.
Gestosis, which increases blood pressure. An epidural helps lower blood pressure.
Mismatch of labor activity, which is a consequence of excessive work of the muscles of the uterus.
Anesthesia reduces the intensity of contractions and allows the muscles to relax.
Prolonged childbirth that exhausts a woman and does not allow her to relax.
Also, with a caesarean section, epidural anesthesia is done.

Contraindications for epidural anesthesia

Epidural anesthesia- a rather serious procedure, the implementation of which can lead to serious consequences. Therefore, she has a number of contraindications:

Consequences and complications after epidural anesthesia during childbirth

Complications and undesirable consequences during this type of anesthesia may be as follows:

Not all patients are fully anaesthetized, so anesthesia may be partial or absent altogether.
Bupivacaine can have a toxic effect on the body.
If the dura mater was damaged during the puncture, then the cerebral fluid may leak into the epidural region. This leads to headaches after childbirth. Such a complication may pass in a few weeks, or it may take years.
Too much anesthetic can be toxic, reducing the effectiveness of pain relief.
If the anesthetic gets through the blood to the brain, it can cause spasms and unconsciousness.

If a nerve was damaged during the piercing, then this can cause numbness in the legs. Usually it passes quickly, but there are cases when the complication remains for life. Risk of serious complications when conducting an epidural, it is very low - there is only 1 case per 80,000 women in labor.

Failed epidural anesthesia

According to statistics, epidural anesthesia has no effect in 5% of cases, and in 15% it relieves pain partially. There may be several reasons for this:

The anesthesiologist was unable to insert the needle into the epidural space. This may be due to the inexperience of the doctor, anomalies in the structure of the spine, or the excessive fullness of the woman.
Due to the connecting septa in the epidural area, the drug may spread unevenly. This causes the pain to go away from the right or left side of the body. Such an anomaly can be eliminated by increasing the dose of the drug.
Individual immunity to anesthetic. For some people, not all drugs may have an analgesic effect.

Like any medical procedure, an epidural has its pros and cons. Let's analyze them in more detail.

Advantages

The method is considered one of the strongest and most reliable for labor pain relief.
The action of the drug begins relatively quickly - 40 minutes after the installation of the catheter.
The woman in labor remains conscious and feels contractions.
In some cases, such anesthesia helps labor activity: it reduces pressure, relaxes the uterine muscles, and gives the woman in labor time to rest.
A caesarean section can be performed using a stronger anesthetic.

Negative aspects of the procedure

For complete anesthesia, the introduction of a large amount of the drug is required, which can adversely affect the body of the mother and child.
Anesthesia in some cases causes severe chills, fever, or itching.
Restriction of mobility - the woman remains in a supine position until the end of the procedure.
To empty the bladder, you will have to attach a catheter.
During the entire birth process, doctors will monitor the baby's pulse and constantly measure the woman's blood pressure.
As contractions subside, it may be necessary to induce labor with oxytocin.
There is an increasing need to use forceps to extract the baby.
Headaches or numbness in the legs when pierced incorrectly.

Video about epidural anesthesia during childbirth

We suggest watching this video, which details the effects of epidural anesthesia on a woman and a child. The psychological factors associated with the procedure are described in detail. Also listed the main disadvantages and advantages of such anesthesia.

In theory, you can talk a lot about childbirth and the possibilities of pain relief, but how does it work in practice? Dear mothers who have gone through this procedure, share with us your experience. Your help will be invaluable for those who have yet to go through a difficult but joyful test of childbirth.

Often, an anesthetic and glucocorticosteroids.

Is epidural anesthesia included in the birth certificate?

It depends on the circumstances.

If epidural anesthesia is performed according to indications, then it is included in the birth certificate. In this case, this type of medical care is provided free of charge.

But epidural anesthesia can also be performed at the request of the woman herself. In this case, it is an additional paid service that will have to be paid in full.

Is epidural anesthesia done during laparoscopy?

Epidural anesthesia is performed during laparoscopic surgical interventions, including in gynecology. But it can only be used for short-term procedures and those that are performed on an outpatient basis (without hospitalization). Disadvantages of epidural anesthesia in laparoscopic surgery:

Higher risk of oxygen starvation due to increased blood levels of carbon dioxide.
Irritation phrenic nerve, whose functions are not disabled during epidural anesthesia.
Possibility of aspiration - the ingress of saliva, mucus and stomach contents into the respiratory tract as a result of increased pressure in the abdominal cavity.
With epidural anesthesia, it is often necessary to prescribe strong sedativesthat can suppress breathing - this further increases oxygen starvation.
Higher risk of disruption of the cardiovascular system.

In this regard, epidural anesthesia is of limited use in laparoscopic operations.

What drugs are used for epidural anesthesia?

Name of the drug	Description
Novocaine	Currently, it is practically not used for epidural anesthesia. Begins to act slowly, the effect does not last long.
Trimecain	It acts quickly (numbness begins after 10-15 minutes), but not for long (the effect stops after 45-60 minutes). Most often used for epidural anesthesia through a catheter or in combination with other anesthetics.
Chlorprocaine	Just like trimecaine, it acts quickly (numbness begins after 10-15 minutes), but not for long (the effect stops after 45-60 minutes). It is used for short-term and outpatient interventions, as well as for epidural anesthesia through a catheter (in this case, it is administered every 40 minutes).
Lidocaine	It begins to act quickly (10-15 minutes after administration), but the effect persists for a long time (1-1.5 hours). It can be administered through a needle or through a catheter (every 1.25-1.5 hours).
mepivacaine	Just like lidocaine, it begins to act in 10-15 minutes and ends in 1-1.5 hours. It can be given through a needle or through a catheter, but this drug is not recommended for long-term pain relief during childbirth, as it enters the bloodstream of the mother and baby.
prilocaine	The speed and duration of action - as in lidocaine and mepivacaine. This drug is not used for long-term pain relief and in obstetrics, as it negatively affects the hemoglobin of the mother and fetus.
Decain	It begins to act slowly - 20-30 minutes after administration, but the effect lasts up to three hours. This is sufficient for many operations. But it is important not to exceed the dose of the anesthetic, as otherwise its toxic effects may occur.
Etidocaine	Begins to act quickly - in 10-15 minutes. The effect can last up to 6 hours. This drug is not used in obstetrics, as it causes a strong relaxation of the muscles.
Bupivacaine	Begins to act in 15-20 minutes, the effect lasts up to 5 hours. In low doses, it is often used for labor pain relief. This anesthetic is convenient because it acts for a long time and does not lead to muscle relaxation, so it does not interfere with labor. But with an overdose or introduction into a vessel, persistent toxic effects develop.

What drugs can affect epidural anesthesia?

Taking drugs that reduce blood clotting is a relative contraindication to epidural anesthesia. Between taking the medicine and the procedure, a certain time must pass for its effect to stop.

Name of the drug	*What to do if you are taking this drug?**	What tests should be done before epidural anesthesia?
Plavix (Clopidogrel)	Stop taking 1 week before anesthesia.
Ticlid (Ticlopidin)	Stop taking 2 weeks before anesthesia.
Unfractionated heparin(solution for subcutaneous administration)	Perform epidural anesthesia no earlier than 4 hours after the last injection.	If treatment with heparin lasted more than 4 days, it is necessary to take a complete blood count and check the platelet count.
Unfractionated heparin(solution for intravenous administration)	Perform epidural anesthesia no earlier than 4 hours after the last injection. Remove the catheter 4 hours after the last insertion.	Definition prothrombin time.
Coumadin (Warfarin)	Conduct epidural anesthesia no earlier than 4-5 days after discontinuation of the drug.	Before anesthesia and before removal of the catheter: definition prothrombin time; definition international normalized ratio(indicator of blood coagulation).
Fraxiparine, Nadroparin, Enoxaparin, Clexane, Dalteparin, Fragmin,Bemiparin, Cibor.	Do not enter: in a prophylactic dose - 12 hours before the procedure; in a therapeutic dose - 24 hours before the procedure; after surgery or removal of the catheter - within 2 hours.
Fondaparinux (Pentasaccharide, Arikstra)	Do not inject within 36 hours before anesthesia; do not inject within 12 hours after completion of surgery or removal of the catheter.
Rivaroxaban	Epidural anesthesia can be performed no earlier than 18 hours after the last dose; administer the drug no earlier than 6 hours after the completion of the operation or removal of the catheter.

*If you are taking any of these medications, be sure to tell your doctor. Do not stop taking on your own.