Epidural anesthesia with caesarean section is used as the basis of the type of anesthesia. This type of regional anesthesia is highly effective, has small side effects. Consider it in more detail, highlighting the indications, features of the conduct and contraindications.
Epidural anesthesia - indications
Epidural anesthesia with cesarean is carried out at the desire of the woman in labor. Many future mothers who are prescribed a planned section prefer directly to this type of anesthesia. With such anesthesia, the woman remains conscious, hears the first cry of her baby, but does not feel anything at all. There are also factors in the presence of which epidural anesthesia is mandatory for cesarean. Among them are:
- presence of preeclampsia ;
- high blood pressure;
- liver and kidney disease;
- pronounced myopia;
- diabetes;
- contraindications to general anesthesia;
- excessive labor activity;
- pathological conditions of the uterus.
How is the cesarean section with epidural anesthesia?
Women, preparing for surgery, are often interested in doctors, as do caesarean section with epidural anesthesia. Before the beginning of an operation, the pregnant woman sits down on the couch, or lies on her side. The area of the spinal column where the needle is inserted is carefully treated with an antiseptic. After the onset of anesthesia, doctors perform an incision in the lower abdomen, somewhat above the pubic area. On the surgical wound, expanders are placed, opening access to the fetus.
After a neat opening of the bladder, the doctors begin to extract the fruit outside. After the successful completion of this stage, the baby is cut the umbilical cord and the clamp is applied. Mom is given oxytocin, for the separation of the afterbirth. After this, the suturing is carried out. In place of the seam a few months later there is a scar, which is almost invisible, does not cause Mom inconvenience.
How is epidural anesthesia done at a caesarean section?
Epidural anesthesia in cesarean section is often introduced in the sitting position. In this case, the patient is offered to take a position: legs to dissolve in the knees, put the ankles on the bed, bend the back, tilting the cervical section. Alternative is the location of a woman lying on her side (more often on the right). However, medical practice shows that it is easier to administer anesthetic in the patient's sitting position.
Anesthetic, with the help of a special needle, is inserted into the space between the wall of the spinal canal and the hard shell of the spinal cord (epidural space). A special, thin sterile tube (catheter) is inserted through the needle, which is left for the injection of an anesthetic. Epidural anesthesia, with a caesarean section, involves dosing the drug: increasing the concentration or stopping its supply.
Is it painful to do epidural anesthesia with cesarean?
This procedure, like epidural anesthesia, is practically painless for the patient herself. Before the puncture, doctors perform local anesthesia. A slight discomfort, mild pain pregnant can feel only at the time of puncture. In the rest the procedure does not cause pain, it is perfectly tolerated by women in position. The experiences of a future mother, regarding the painfulness of such manipulation, as epidural anesthesia in cesarean section, are groundless.
How long does the cesarean section last for epidural anesthesia?
Cesarean section under epidural anesthesia lasts no more than half an hour. At the same time, on average, from the moment of administration to extraction of the fetus outward from the abdomen, it takes 10-15 minutes. The rest of the time is spent on suturing the postoperative wound. At the same time, a woman is administered a hormone for the removal and birth of the placenta. In order to prevent infection, mom is given antibacterial drugs.
Cesarean under epidural anesthesia - sensations
With the proper carrying out of anesthesia, a woman does not feel anything during the operation. Sensations in the caesarean section under epidural anesthesia are associated with the onset of the action of the anesthetic. After the injection, the pregnant woman begins to note the warmth, the feeling of heaviness in her legs. After a while, the future mother does not completely feel the lower part of the trunk - anything below the injection site. A slight numbness spreads throughout the body. This phenomenon can be accompanied by slight tingling, a feeling of goosebumps, which disappears after complete anesthesia.
How many epidural anesthesia after cesarean?
Epidural anesthesia with caesarean is about 2 hours. Immediately during this time, doctors forbid a woman to get up after the operation. With this type of anesthesia, the blood flow in the lower extremities slows down. Because of this, if you try to get up, there is weakness in your legs - there is a high probability of falling. In addition, often after the operation there are headaches, dizziness, which worsen the well-being of the newly mum.
Epidural anesthesia in caesarean section - consequences
The consequences after epidural anesthesia in a cesarean section are often associated with non-compliance with contraindications to her behavior or with a violation of the algorithm of anesthesia. In this case complications can be noted, both from mother and baby. Follow the consequences of epidural anesthesia for parturient women (during labor):
- trauma of the hard shell of the spinal cord;
- decreased heart rate;
- the appearance of nausea and vomiting;
- an allergic reaction to the anesthetic.
Disturbances can develop in a newly mum in the postpartum period:
- pain in the back and head;
- violation of lactation ;
- decreased sensitivity of the legs;
- disruption of the CNS.
Poorly performing epidural anesthesia with caesarean section may also affect the baby's condition:
- decrease in heart rate (bradycardia);
- violation of the breathing process;
- violation of the sucking reflex;
- disorientation;
- encephalopathy.
Back pain after epidural anesthesia with cesarean
Epidural anesthesia with caesarean, the consequences of which are named above, often turns into a woman's back pain after the birth of the child. There can be many reasons for this. Dangerous is epidurit - an inflammatory process in the epidural space. This complication develops because of the prolonged location of the catheter in the back or when part of it remains. In addition, the pain may worsen after surgery due to the available vertebral hernia.
Other causes of pain in the back area are directly related to improper conduct of a procedure such as epidural anesthesia in a cesarean section, the body's response to an anesthetic. Due to a lack of extensive experience, a doctor may injure the injector with a hard shell, where the nerve roots are located. Separately, it is necessary to distinguish phantom pain, which is directly related to the psychological state of the patient.
Headaches after epidural anesthesia with cesarean
Telling about the consequences and complications of epidural anesthesia in cesarean section, it is necessary to distinguish and frequent headaches after the operation. Their appearance is associated with the effect of an anesthetic component on the body. This reaction is observed in 50% of patients who underwent epidural analgesia. Duration of painful sensations - from several hours to several weeks. Headache can be caused by a change in intracranial pressure, because of the outflow of cerebrospinal fluid into the epidural space (with damage to the brain membrane).
Such situations require surgical intervention. The operation consists in repeated puncture and suction of the fluid with the aid of a special apparatus. After manipulation, a blood patch is placed on the puncture site. The patient's blood taken from the vein is injected at the site of the puncture. As a result, the outflow of cerebrospinal fluid is blocked. Relief of well-being woman notes already the next day after the procedure.
Epidural anesthesia with caesarean section - contraindications
This type of regional anesthesia may not always be used. And any medical manipulation, prohibitions on carrying out and has epidural anesthesia with Caesarean, contraindications for the implementation of which are the following:
- patient's refusal;
- absence of special equipment or qualified specialist;
- severe hemorrhage;
- dehydration of the body;
- disruption of the blood coagulation system;
- hypotension;
- taking anticoagulants ;
- spinal injury;
- high intracranial pressure;
- an allergic reaction to the anesthetic;
- heart rhythm disturbances;
- fetal hypoxia ;
- malformations of the fetus.