The space between the inner surface of the bone channel of the spine and the dura mater is called epidural. Through the dura mater, nerve rootlets emerge into it, and the administration of preparations for local anesthesia prevents the impulse from passing through them. Due to this, it is possible to achieve a loss of sensitivity and motor activity in a specific part of the body, if an anesthetic is injected into the epidural space of a specific spine.
In order to anesthetize birth, inject substances that provide only a loss of sensitivity, and when a cesarean section is done under epidural anesthesia, then drugs that disable motor activity are added. Through the needle into the epidural space, a catheter is inserted, the needle is removed, and an anesthetic is injected periodically into the catheter fixed to the shoulder from the beginning of regular bouts: lidocaine or more modern preparations.
Childbirth under epidural anesthesia
After listening to stories from friends about childbirth with epidural anesthesia, many women, feeling fear of childbirth, begin to be interested in this method of anesthesia. There seems to be no exact indication for this method, except as a desire to reduce pain during labor. But epidural anesthesia does not affect the fetus directly: the drug does not pass the transplacental barrier. In addition, with natural childbirth, epidural anesthesia does not affect the course of the periods of labor: contractions occur, the cervix is opened, but there is no pain. It lowers blood pressure, which is good for gestosis of pregnancy, and this method of anesthesia can be used at any age, there are not a number of complications that are unavoidable with general anesthesia of labor.
Epidural anesthesia in childbirth - cons
What positive feedback would not be, epidural anesthesia is a method in which very much depends on the qualification of an anesthesiologist and any errors in its conduct can cause severe consequences after childbirth due to epidural anesthesia. Of these consequences, the most severe are paresis and paralysis with damage to the nerve endings. Possible weakness of labor, violation of the heart rhythm in both the mother and the fetus, a violation of thermoregulation (the method causes an increase in body temperature), disruption of the bladder. There may also be a disturbance in attempts, which may necessitate the extraction of the fetus (by the application of forceps).
Contraindications to epidural anesthesia during childbirth
Epidural anesthesia is a method that has more contraindications than indications. First of all, it is contraindicated in cases of hypersensitivity to local anesthetics. Contraindications also include:
- bleeding;
- blood clotting disorders;
- hypovolemic and traumatic shock;
- epilepsy;
- organic lesions of the central nervous system;
- diseases of the spinal cord;
- increased intracranial pressure;
- arrhythmia and severe cardiac dysfunction;
- intestinal obstruction.
Do not perform anesthesia in the presence of skin inflammation or tattoos at the injection site. A relative contraindication may be obesity: the introduction of a needle through a thick subcutaneous fat layer is difficult for doctors.
Consequences of epidural anesthesia after childbirth
Many women complain that a few months after the procedure they were disturbed by severe headaches after accidental puncture of the dura mater, there were paralysis and paresis, incontinence of urine and feces, if difficulties arose with the extraction of the fetus and this caused various traumas in the child. Headaches are one of the most frequent unpleasant consequences of epidural anesthesia, the appearance of which marks a large number of women giving birth to such anesthesia.
But the feedback on how the cesarean section was used, when epidural anesthesia was used, is much better than those who were made under general anesthesia, since there are fewer complications in the mother and child from the most general anesthesia. According to the stories of many women, the main discomfort in the operation under the "epidural" was the need for them to be conscious, fearful that it would hurt, as well as subjective discomfort from the paralysis of the lower body.
The majority of women notice and one more unpleasant feature of epidural anesthesia - when anesthesia departs, the strongest chill begins, which can be managed only with the help of additional medication.
If the health, psychological and physical preparation of a woman for childbirth allows - it is better not to resort to anesthesia, since any intervention in natural processes without valid reasons can have very different negative consequences.