Consequences after epidural anesthesia. Pros and cons of epidural anesthesia

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

Epidural anesthesia is a kind of anesthesia local application. She anesthetizes contractions, which for a woman are sometimes simply unbearable.

Anesthesia is injected into the lumbar spine, where the epidural space is located. It contains spinal roots nerve endings pelvic organs, including the uterus. Anesthesia blocks pain and a woman can a long period feel no contractions at all unpleasant symptoms. 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, epidural anesthesia is widely used today 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 during natural childbirth, the effect of epidural anesthesia continues only during contractions, when the cervix opens so that the baby can pass through birth canal. A woman is forced to endure attempts without anesthesia, but they do not last long, so they can be endured.

If a woman needs to apply epidural anesthesia purely for medical indications, then she is given it for free, but if she herself 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 the process of administration spinal anesthesia just 10 minutes. It requires highly qualified anesthesiologists and adherence to strict rules:

A pregnant woman should bare her back, sit down, bend 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 unnecessary body movements can lead to many complications.
The doctor treats the place to be pierced with a special antiseptic.
After that, the anesthesiologist will anesthetize the area that will be pierced. For this, the banal Lidocoin is used.
After that it is used special set for epidural anesthesia - a special needle with anesthesia is inserted (it will work 20 minutes after injection). It must 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 the contraction. If you feel that the fight is coming, then tell the doctor, because at the time of the spasm you can move, and this will lead to disastrous consequences.
After delivery, the catheter is removed from the woman's back, but within 2-3 hours after the epidural anesthesia, the doctor will recommend that the woman in labor remain in a stationary position.

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

Gradually, introducing small doses.
Once, by administering the entire dose of the drug at once. With this method, a woman cannot get up, because the components of anesthesia will expand the vessels of the legs, the woman in labor simply will 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 maternity hospital

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

If a woman started premature birth. To a premature baby with a relaxed cervix under the influence of anesthesia, it will be 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 a woman in labor has too high blood pressure, at which a woman cannot give birth herself. Epidural anesthesia, according to reviews, perfectly reduces pressure.
If a woman has 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 the birth is delayed, and the pregnant woman can no longer endure labor pains, then she is given anesthesia.

Contraindications for 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;
problems with blood poor clotting, infection);
bleeding;
individual intolerance to the components of anesthesia;
the woman is unconscious;
heart or vascular diseases;
do not do epidural anesthesia for a hernia of the lumbar spine.

Complications of epidural anesthesia

After epidural anesthesia, a woman may experience some complications:

The doctor may accidentally get into the venous bed of the spine, and then the woman will begin to have headaches after the introduction of epidural anesthesia, she will feel sick, her tongue will become numb.
Could happen anaphylactic shock(this happens if the woman does not know that she has an allergy).
Quite rarely, there is such a consequence of epidural anesthesia as shortness of breath.
In addition, women in labor often complain of back pain after epidural anesthesia. Your 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 administered in order to inject the woman's blood there, which will seal the puncture site.
After epidural anesthesia, the legs can be taken away, but this happens only if the technology for introducing anesthesia was incorrectly carried out.
After giving birth with epidural anesthesia, a woman may have difficulty urinating.

To avoid negative consequences after 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

The main advantages of spinal anesthesia during childbirth include:

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

Among the main disadvantages of epidural anesthesia:

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

Your main task is to listen carefully to the doctor what to do after epidural anesthesia. Following your doctor's advice will help prevent possible complications and properly recover from spinal anesthesia.

Video: "Epidural anesthesia"

Epidural anesthesia (EA) - when is it used? In the lumbar region of the spine, the spinal roots exit into the epidural space. Nerve impulses are transmitted through them from all organs of the small pelvis, including from the uterus.
The doctor enters anesthetic drugs that block the transmission of pain signals to the brain. As a result, the woman in labor does not feel pain caused by contractions. But the dose is calculated in such a way that the woman does not feel anything below the waist, but at the same time she can walk herself. Such anesthesia allows her to be fully aware of what is happening and to be conscious. It is used when a caesarean section is performed.

Note that the action of EA, if there is no individual indications, is used exclusively during the opening of the cervix. Attempts and the birth itself, of course, future mom overcome without anesthesia.

indications for epidural

The main indications for EA are such factors as:

high blood pressure in a woman during pregnancy and childbirth (it is recommended to turn off pain sensitivity so that the woman does not experience sharp rise pressure);
discoordination labor activity(when the upper segment of the uterus contracts separately from the lower one and its cervix does not open);
severe pathologies internal organs;
preterm birth, when the risk of traumatizing the child is relatively high;
increased pain sensitivity in a woman giving birth.

In absolutely all cases when pain relief occurs, the staff of the medical institution must obtain the written consent of the patient for this procedure. Before signing this document, the anesthesiologist must briefly describe the essence of the technique, its advantages and potential risks. The woman will have to make this decision herself.

Advantages and disadvantages

EA advantages:

the cervix opens faster, which contributes to the smooth movement of the child through the birth canal;
the absence of pain while maintaining a clear mind of the woman in labor;
the opportunity to get rest and save strength for a longer period of labor activity - the opening of the cervix;
the penetration of a small amount of painkiller into the blood of the fetus in such a concentration that it cannot have a significant negative effect on it;
EA is allowed for women who cannot be given inhalation anesthesia;

For women with hypertension, a significant advantage of the method is to reduce blood pressure with drug administration.

Disadvantages of the epidural method of anesthesia:

against the background of a reduction in the period of cervical opening, the time of expulsion of the fetus is lengthened (this leads to a longer duration of labor, a frequent number of ruptures and obstetric manipulations);
if the expectant mother suffers from hypotension, then she cannot do EA;
do not use this type of anesthesia for sepsis, some spinal deformities, bleeding disorders, bleeding or inflammation in the area of the proposed puncture site.

Note that, like other medical manipulations in which a drug is administered, EA can cause whole line additional negative effects And different kind complications.

Consequences

After the introduction of this type of anesthesia, most often after childbirth, there is headache. It occurs when a hard tissue is accidentally pierced with a needle. meninges And cerebrospinal fluid flows into the epidural region. Pain in mild form disappears in a few days. However, there are cases when a similar result of anesthesia lasted attention! weeks, months and even! years. It's very rare, but it does happen.

The most typical consequences of EA:

back pain;
lowering blood pressure;
education spinal hernia at the insertion site of the medical tube;
an allergic reaction to the administered drug, as its result: the feet and legs swell.

There are a number of other complications of EA:

partial or complete absence anesthesia (and this is in every 20th patient!);
the formation of a bruise at the injection site in those who suffer from coagulopathy;
toxic effect bupivacaine;
fainting and convulsions are sometimes observed;
very rarely, but, nevertheless, it cannot be said that such a complication as paralysis occurs.

It should be noted that it is advisable to select an anesthesiologist in advance. Good and strong specialist will normally carry out the process of anesthesia with least consequences. In EA, the skill and experience of the doctor plays a big role.

To agree to this type of anesthesia or not, it is up to the expectant mother to decide. No matter what decision you make, let pregnancy will pass well, go to the maternity hospital good mood! We wish you easy painful childbirth and the birth of a healthy, beautiful baby!

Epidural anesthesia during childbirth, or "epidural" as it is often called by pregnant women, is used to local anesthesia. Epidural anesthesia is considered a safe, very effective and easy to use method that allows a woman to become a happy mother without experiencing labor pain.

Doctors confidently recommend epidural anesthesia during childbirth, and many women take this step simply because they see no point in enduring pain if they can do without it. Moreover, for some women, exhausted by a long period of contractions, epidural anesthesia is a real salvation: the cervix opens - and childbirth magically occurs very easily and quickly. Therefore, reviews of mothers about epidural anesthesia during childbirth are often positive.

However, let's look at the birth process from the point of view of physiology and psychology. What are the consequences of epidural anesthesia? What does a woman lose by getting rid of pain with the help of medicines? How does epidural anesthesia for childbirth for a newborn baby?

In this video, Larisa Sviridova answers questions about epidural anesthesia during childbirth.

Question: “I have come across information more than once that during childbirth, a woman’s body produces substances that help to cope with pain. Together with the mother's bloodstream, the child also receives these substances. If epidural anesthesia is used during childbirth, then the mother does not experience pain, defense mechanism is broken, and the child takes all the pain on himself. Is it so?"

Epidural anesthesia during childbirth. Video.

Watch our video and you will find out when epidural anesthesia is really justified during childbirth and what are the consequences of epidural anesthesia. All questions can be asked in the comments.

Haha, funny. I literally just read on a respected medical resource that because of the epidural, the mother “loses” the emotional connection with the child. After all, the whole process of childbirth at the same time turns into an act of "extracting the child from the womb." To be taken out of you like that! So - epidural anesthesia consequences for the child?

Like any violation of the integrity of tissues human body, epidural anesthesia may have consequences for the woman in labor. But it is the mother who takes the brunt. A woman may have a headache, some pain may be felt, and the immobility of one or both legs may remain. And only with complications, the appearance of severe consequences The child has.

Doesn't fall into systemic circulation. The drug is injected into the epidural space - a small gap in which cerebrospinal fluid flows, a fluid that protects spinal cord. And that's where lidocaine comes into play. Which is used for pain relief. It simply "freezes" the nerve receptors of the lower back, reducing the manifestation of pain.

Can lidocaine get into a child? Purely theoretically, yes. But for this he must get into the blood, pass through circulatory system mother, pass through the placenta and only then enter the bloodstream of the baby. In practice, this is impossible, since the cerebrospinal fluid is constantly updated, the medicine is simply “diluted” with cerebrospinal fluid, like water, and leaves the body.

worsens due to anesthesia uterine blood flow. In this case, the child may begin tachycardia, develop oxygen starvation. On personal experience I can say that there must be prerequisites for this. During the entire period of childbirth, I was connected to a machine that takes CTG from a child. And combination negative factors(maternal epilepsy, critical oligohydramnios, low birth weight of the fetus) did not worsen the heart rate for more than a minute, despite the epidural.

What negative consequences can be observed after childbirth?

I had a second birth epidural anesthesia, consequences for the child were also. But I do not consider them critical in comparison with those that could have been if anesthesia had not been performed.

So, the problem I faced was that after giving birth, I slept all the time. She was given after treatment literally 3 hours after birth. I tried to feed her. But the baby did not breastfeed. After a couple of hours, the baby pooped - the meconium departed. And she slept again. Fortunately, she wrote, and looked quite well, pink, did not cry, calmly snuffled.

It was possible to stick the breast in only 12 hours (!!) after the birth. And not to say that she managed to eat a lot. At night, she slept again. No, the son I gave birth nine years ago also slept like a groundhog for five days after giving birth. As they explained to me, birth stress, overwork, and colostrum affect children - very fatty, it is needed a little for feeding.

But my daughter didn't eat! I got scared and went to the pediatrician. The neonatologist examined the baby, rubbed her ears, the child did not wake up. The doctor looked at the card and said that lethargy and drowsiness were the consequences of the epidural. This condition will pass no earlier than a day after delivery. So far, the only thing I need to do is constantly keep my breast under my daughter's nose and periodically change her diaper.

It was scary, to be honest. But at night (more than a day after the birth), my child woke up abruptly and began to eat! She ate for almost two hours, occasionally falling asleep.

I want to point out the violation emotional connection. You should not hope that you will be anesthetized the whole process and you will give birth, you did not feel anything. Contractions last 3 hours or more! And anesthesia lasts a maximum of 4 hours. On the attempts I had such wild pain that I wanted to strangle a couple of obstetricians or tie legs in a knot gynecological chair. So you need to take into account the fact that anesthesia does not last long.

When my daughter was born, I was flooded with such a wave of love that I wanted to cry. And I still feel more tender maternal feelings for her than I felt for a newborn son, the birth with which I was not anesthetized. We have preserved an emotional connection with our daughter, she is very tender, “sticky”. Therefore, I see no reason to refuse anesthesia, which is mandatory for medical reasons due to a hypothetical “loss of communication”.

Will epidural anesthesia have consequences for the child? It all depends on how carefully the procedure is carried out. There will be no complications for the mother - everything will be fine with the baby.

Many expectant mothers are worried about upcoming birth they are often scared severe pain and severe consequences. Reinforce these negative emotions stories of other mothers who gave birth to children on their own, as well as stories in networks and forums.

It is not advisable for a pregnant woman to wind herself up by listening to these stories; if possible, this should be avoided. How calmer mom the faster the birth. physical sensations, which at the same time a woman experiences during childbirth, is not pleasant. It is they who help to realize the birth of a new life. Epidural anesthesia during childbirth makes it possible to alleviate the suffering of the woman in labor. With the help of it, a woman will be able to more easily endure contractions and labor pains.

What is epidural anesthesia?

IN lumbar of the spine, namely, in the epidural space there are spinal roots, through which the transmission of all nerve impulses from the pelvic organs. The introduction of painkillers blocks the supply of pain impulses to the brain, due to this, the woman in labor ceases to feel contractions. Epidural anesthesia during childbirth allows the expectant mother to be fully conscious.

It should be noted that epidural anesthesia during natural childbirth acts only during contractions to open the cervix, attempts pass without anesthesia. Such anesthesia is aimed at giving the woman in labor a rest before the very attempts. Specialists must accurately calculate the administered dose. Attempts and prenatal hours are carried out by a woman in labor without the use of anesthesia in order to reduce Negative influence on the health of mother and child.

Is the administration of anesthesia necessary?

The woman in labor independently decides whether to do epidural anesthesia during childbirth or not. special indications to its introduction does not exist, so the expectant mother must decide in advance whether to use this type of anesthesia or not. Typically, this anesthesia is given with severe pain contractions during natural delivery. Also, epidural anesthesia is successfully used for cesarean delivery, instead of general anesthesia. It is better if the operation takes place in the full consciousness of the mother, without any severe pain.

In addition to relieving cramping pain, epidural anesthesia during childbirth shortens the period of uterine dilatation. The composition has no effect on the newborn, since it penetrates into the blood in negligible doses.

Many women, panicky afraid of pain, try to anesthetize childbirth for another early stage. We can say that this is their whim, but experts say that if mommy is afraid of the upcoming birth, then slight pain can cause severe stress not only for her, but also for the unborn child. The stressful course of childbirth does not bring anything good, so experts do not dissuade such mothers.

Women who have given birth to a child through epidural anesthesia are no different from others. They felt minimal pain during contractions, which is a huge plus, because they have only pleasant memories of the birth process. According to many psychologists, women are more willing to go to the second birth after epidural anesthesia.

The main differences between epidural and spinal anesthesia

Spiral and epidural forms of anesthesia are very similar in terms of the spectrum of effects on the body, only spinal anesthesia is injected deep into the spinal cord. It acts a little differently, the patient's reaction to it is also different. These types of anesthesia differ in the degree of impact and the duration of the effect. Epidural anesthesia during childbirth is recognized as one of the safest and most gentle methods of reducing pain during labor. The cost of the administered drugs is the same. If a woman gives birth in a simple maternity hospital, then epidural anesthesia is administered to her free of charge.

How much does epidural anesthesia cost for childbirth in private clinics? If in private, or at the request of the woman in labor, epidural anesthesia is administered during childbirth, the price of this service ranges from 3 to 5 thousand rubles.

Insertion Procedure

To administer epidural anesthesia, the woman in labor is placed on her side, her back is bent, as in a ball position, then the anesthetic is gently injected. The puncture point can be additionally anesthetized or wiped with alcohol. To make it easier for a woman in labor to endure contractions during childbirth, a catheter is inserted into her back to gradually supply an anesthetic.

If, during the introduction of the catheter, the expectant mother begins to experience strong contractions, it is better not to intervene in natural process let her do everything on her own. During the initial administration of the drug, the patient may experience various side effects eg nausea, numbness of the lower body, dizziness. If such effects are observed, the attending physician should be informed immediately.

Do not worry about the consequences of anesthesia for the baby, since it practically does not enter the bloodstream. The only thing unpleasant feeling for a woman, this is a few seconds of introducing a catheter into the back, then, after 20 minutes, the remedy begins to act. small consequences epidural anesthesia after childbirth are waiting only for a woman. The fact is that a woman after anesthesia is not able to control her pain and natural sensations during childbirth. It is important to remember that this form of anesthesia is not suitable for all women.

Main contraindications for epidural anesthesia

This type of anesthesia has many contraindications that must be taken into account when prescribing it, otherwise there is a risk of worsening the condition of the woman in labor.

The introduction of anesthesia is contraindicated in the presence of the following diagnoses in a pregnant woman:

Having problems with blood clotting;
Various birth hemorrhages;
The presence of a lesion skin at the point of introduction;
cardiac arrhythmia;
Tattoo or infection at the injection point;
Increased body temperature;
Allergy to anesthetic;
heart defects;
Intestinal obstruction;
Diseases of the spinal cord.

The young age of the woman in labor, obesity, low blood pressure are also contraindications to the introduction of this drug. Epidural anesthesia during childbirth is also prohibited if there are some types of curvature of the spine.

Epidural anesthesia during childbirth: indications

Epidural anesthesia during childbirth is used in the following cases:

It is introduced during premature pregnancy, the introduction of a certain dose of this drug helps to accelerate the relaxation of the pelvic muscles, as a result of which the woman in labor does not experience excessive pain due to the fact that her body has not yet had time to prepare for childbirth;
During the irregular course of labor, when deep attempts begin with slight contractions of the uterus, the drug will help activate the muscles;
If a woman in labor has a very high level of blood pressure, the anesthetic helps to normalize and maintain it throughout labor;
It is actively used if unforeseen complications arise, for example, when large fruit or during a multiple pregnancy;
Difficult or prolonged childbirth cannot do without this anesthetic. This drug will help speed up natural opening uterus.

All these situations are indications for the appointment of epidural anesthesia.

Likely consequences

What are the results of epidural anesthesia during childbirth? The consequences of its introduction may be different for the woman in labor:

The anesthetic can penetrate into any venous bed, causing nausea, numbness of the tongue;
During the initial administration, various allergic reactions. To reduce the likelihood of adverse reactions first introduced small dose drug;
Some breathing difficulties may occur due to the effect of the anesthetic on the nerves;
Head and back pain. Arise pain at the puncture site, resulting in a small amount cerebrospinal fluid enters the epidural space. In some situations, pain is relieved by a second puncture of the catheter insertion point;
Also, the level of blood pressure may drop sharply, in order to prevent this, anesthesiologists inject the drug with a dropper, after a puncture and installation of the catheter, they recommend lying down a bit.

Failure to administer anesthetic

As the saying goes official statistics, in 5% of cases the anesthetic does not work at all, that is, anesthesia does not occur, and in 15% this occurs only partially. This is due to the fact that getting into the epidural space is quite difficult, the reasons for unsuccessful anesthesia may be the inexperience of the anesthesiologist, the fullness of the woman in labor, various anomalies spinal column. If the pain is felt by the woman in labor partially, in a certain place, then it is best to make another puncture. This fact of lack of anesthesia must be reported to the anesthesiologist, he will increase the dose of drugs and make an additional puncture.

Epidural anesthesia during childbirth: FOR and AGAINST

What gives epidural anesthesia during childbirth, the pros and cons of this anesthetic, a woman should study before experiencing new drug on myself. While identifying the advantages of this form of anesthesia, it is not necessary to compare it with other types of anesthesia, it is necessary to identify its advantages in comparison with natural childbirth without medical care. Epidural anesthesia during childbirth has the following advantages over the natural process:

The possibility of anesthesia of labor activity, the transformation of the process of childbirth into a more comfortable time, without severe pain;
The opportunity to relax during prolonged childbirth;
Elimination of the risk of high blood pressure in a woman in labor who is at risk due to high blood pressure.

The disadvantages of this procedure are the following:

Possible postpartum complications;
Unexpected consequences after the introduction of epidural anesthesia;
Various birth complications;
Violation of psycho-emotional contact with the child, this invisible connection that in the greatest way felt during childbirth without medication;
There may be a slight tingling sensation in the back;
Trembling all over;
There are difficulties with urination due to muscle hypotonia;
A prolonged headache may occur, which in some cases lasts up to 3 months after childbirth;
There may be pain in the lumbar region.

This form of anesthesia has its real pros and cons. It really helps to facilitate the process of childbirth if the body cannot cope with these sensations on its own. Some short-term complications after anesthesia can be easily treated with medication.

The theory of emotional connection between mother and child during childbirth

Some experts are of the opinion that the introduction of additional anesthetics during natural childbirth unacceptable. But some mothers who have successfully given birth to a child with the introduction of anesthesia do not attach importance to this theory, which has a lot of positive reviews.

The fact is that during childbirth, mother and baby are subjected to severe stress. If mommy is in a comfortable environment at this time, then the child will learn the world. During the birth process, these two people are inextricably linked by the shared pain that connects mother and baby.

Experts advise mothers to tune in to easy childbirth in other ways, for example, attend courses breathing exercises for pregnant women, do exercises, learn correct breathing, restore a delicate connection with the baby. Many mothers agree in advance with their baby that everything will go well and without consequences. The formation of such an attitude helps a woman in labor to more easily endure all the pains of the birth of her child.

Any pain, including birth pain, causes the release of endorphins into the blood, which are responsible for a feeling of happiness and relief. Having gone through the pain on her own, a woman feels unprecedented happiness and emotional upsurge. And if there is practically no pain, then the woman will not fully feel the joy at the end of childbirth.