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An epidural is the most effective pain relief in labor, but there are other indications for an epidural. When else is an epidural used? What are the contraindications and side effects of an epidural? What is the difference between an epidural and a spinal?

An epiduralis a type of local anesthetic. It consists in introducing a thin polyethylene catheter with a diameter of about 1 mm into the epidural space, located in the center of the spine, and then administering anesthetics through it to relieve pain. The time of action can be freely extended, even up to several days in the case of postoperative pain treatment.

After anesthesia, the patient is awake, but this may be combined with general anesthesia in some cases, or sedation.

Epidural - indications

  • fighting postoperative pain
  • very extensive abdominal procedures (in combination with general anesthesia)
  • vascular procedures, e.g. aortic aneurysm surgery

The epidural takes about 20 minutes to start working.

  • surgery on the lower limbs, e.g. hip replacement, knee surgery
  • childbirth (also caesarean section)

Epidural anesthesia - contraindications

  • infection in the place where the puncture is to be performed
  • blood coagulation disorders
  • certain neurological conditions (e.g. epilepsy)
  • disturbances in the body's water and electrolyte balance
  • hypertension
  • severe congenital heart disease
  • unstable ischemic heart disease
  • advanced changes in the joints of the spine in the lumbar region

    • Epidural - side effects

    • back pain at the injection site, lasting 2-3 days
    • drop in blood pressure
    • arrhythmias, including bradycardia
    • nausea, vomiting
    • urinary retention, difficulty urinating
    • it is very rare to develop during anesthesiaa small hole in the cover of the spinal cord, which causes fluid around the spinal cord to drain out. Sometimes it causes quite a headache. which usually disappears quickly and is treated with the usual painkillers

    Properly performed and administered epidural is safe. There is, of course, some risk, but the immediate availability of a doctor-anesthesiologist reduces any possible risk to a minimum.

    • neurological complications (rare), such as meningitis, epidural or spinal canal hematoma, clumped meningitis, anterior spinal artery syndrome, cauda equina syndrome, persistent lower limb paraesthesia
    Worth knowing

    Is it true that you get severe headaches after an epidural?

    No. Headaches can happen after an inadvertent puncture by a doctor - an anesthesiologist - of the dura mater. In practice, this happens rarely. Pains have no consequences and usually undergo effective treatment.

    Can an epidural damage the spine?

    People suffering from spinal deformity or suffering from diseases related to it in the past, should inform the anesthesiologist about this fact, who will decide whether it is an obstacle to anesthesia. There is no evidence that anesthesia itself causes back pain, and it is often used to treat such conditions.

    Epidural vs. spinal anesthesia

    Spinal anesthesia is applied only in the lumbar spine. An epidural may be additionally applied in the thoracic and cervical sections (very rarely).

    The onset of spinal anesthesia is very quick, and the epidural is slow - it starts working after about 20 minutes.

    Epidural is not only used during surgery, but is also continued in the postoperative period to combat postoperative pain.

    Spinal anesthesia lasts about 3 hours. The duration of epidural anesthesia can be freely extended, even up to several days in the treatment of post-operative pain.

    Subarachnoid anesthesia ensures a relatively long period of painlessness after the procedure. On average, the patient does not hurt for 1-3 hours after the end of the procedure. Thereafter, there is a need to administer intravenous drugspainkillers. By administering medications through an epidural catheter, you can completely control post-operative pain.

    There is no possibility of continuing the analgesic treatment under spinal anesthesia. Under epidural anesthesia, a catheter inserted before the procedure is used to administer painkillers.

    Headaches occur with spinal anesthesia. In this anesthesia, the anesthetist deliberately points the dura mater to administer a local anesthetic to the subarachnoid space, which is positioned behind the dura mater. The anaesthesiologist then implements appropriate procedures to eliminate them. With a properly performed epidural anesthesia, headaches do not arise. They can only annoy when the dura mater is unintentionally punctured.

    Important

    Epidural is a fearless birth

    A frequent source of anxiety for pregnant women, and even for women who are just planning a pregnancy, is the pain of childbirth. Modern medicine offers the pregnant woman an effective weapon in the fight against this pain. The appearance of epidural anesthesia in obstetrics was a breakthrough - it eliminates pain, but does not disturb the feeling of uterine contractions, which allows for active participation in labor. Previously, the pain was relieved by intravenous and inhalation analgesia. However, unlike zzo, drugs administered intravenously cross the placenta, with a risk of respiratory and circulatory complications in the baby. Side effects also occurred in the woman in labor: vomiting, nausea, and somnolence. Access to anesthesia gives the giving birth a sense of comfort and security. Fear disappears, paralyzing the woman in labor, and thus adversely affecting the course of childbirth. However, you should not expect to put on a zzo in advance. Most women, with adequate staff support, do well without it. It is important, however, to be aware that, if necessary, it is possible to quickly become desensitized.

    Epidural in childbirth

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    Category:

    Neurology