Epidural consequences. Is epidural anesthesia included in the birth certificate? Consequences and complications of epidural anesthesia after childbirth

Every day, a large number of operations are performed in medical clinics. Surgery is impossible without appropriate anesthesia, that is, anesthesia is required, otherwise it will be simply unbearable to endure such pain. There are many types of anesthesia. In this article we will look at what epidural anesthesia is, in what cases it can be used, and whether there are any contraindications.

What is epidural anesthesia

This type of pain relief is one of the regional epidural methods - it is the introduction of drugs directly into the epidural space of the spinal column through a catheter. During such anesthesia, the following results can be achieved:

Loss of pain sensitivity.
General sensitivity decreases or almost disappears.
Muscle relaxation.

The mechanism of action of epidural anesthesia is due to the fact that the medicine penetrates through the dural couplings, as a result of which the passage of nerve impulses is blocked.

How epidural anesthesia works

In humans, the spinal column and nerve endings in the neck are located in the dura mater. The epidural region is located around the membrane and runs along the spine. Nerves in the direction of the neck, arms and shoulders cross it, their inflammation leads to pain in the epidural area.

Medicine injected into this area causes loss of sensation and dullness of pain. The transmission of nerve impulses is blocked, which gives this effect.

When is epidural anesthesia used?

Considering that this type of anesthesia is used during surgery in various areas of the body, we can say that the risk of use may be greater or lesser. For example, epidural anesthesia for the chest, groin, legs, and abdomen is less risky than analgesia for the neck and arms. The use of such anesthesia for the head is impossible, because the innervation of this part of the body is carried out using the cranial system.

Epidural anesthesia is most often used:

As a local anesthetic if surgery is not intended, for example, during labor.
As an adjunct to general anesthesia, it is then possible to reduce the amount of opioids used.
Epidural anesthesia is often used for caesarean section.
In the postoperative period to relieve pain.
For the treatment of back pain. In this case, steroid drugs and analgesics are injected into the epidural area.

The doctor decides which anesthesia to give preference to, general anesthesia or epidural, in each specific case.

Methods of epidural anesthesia

Every year, more and more new tools for this type of pain relief appear in the arsenal of doctors. When doctors are faced with a choice: general or epidural anesthesia, then, if possible, choose the latter. A large selection of medications for its implementation allows you to choose the most suitable option for each patient.

In addition to the variety of drugs for anesthesia, there are various methods of such anesthesia:

Continuous. In this case, the anesthetic is continuously injected into the spinal space. In this way, you can achieve pain relief for the entire period of the operation, and less medication will be required.
Periodic administration. The supply of the drug is ensured only when there is an urgent need for it.
Pain relief at the request of the patient. When using this method, the patient has a button under his hands. If there is a need for pain relief, then when you press it, part of the medicine is delivered to the epidural area.

Doctors have medications that perfectly relieve pain, but maintain mobility and keep consciousness clear.

In what cases is epidural anesthesia indicated?

Most surgeons consider this method of anesthesia the most suitable during leg surgery. It allows not only to relieve pain and relax the muscles as much as possible, but also to reduce blood loss.

Indications for the use of epidural anesthesia may vary, for example:

This method is absolutely safe for the kidneys and prostate gland.
Used for abdominal and pelvic organs.
Widely used during surgery on the stomach and intestines.
Can be used for heart defects and diabetes.

But this does not mean that epidural anesthesia is always used for such pathologies. Everything is decided in each case individually.

Contraindications for use

Epidural anesthesia has the following contraindications: categorical and relative. The first category includes:

Relative contraindications are much broader and include:

Excess weight.
Poor body condition.
Chronic diseases of the spinal column.
Childhood.
Diseases of a neurological nature.
Severe hypotension and many others.

The quality of epidural anesthesia will depend not only on the existing pathology and health status of the patient, but also on the drug that is supposed to be used.

Epidural anesthesia for caesarean section

When all the indications for a cesarean section are available, an epidural is often used instead. This method is selected in advance, as it requires some preparation.

The drug is administered to a specific place at the lumbar level, where the nerve endings exit the spinal cord. The drug is administered through a special catheter tube; medication can be added at any time during the operation.

As a result of such anesthesia, consciousness remains clear, and sensitivity below the belt disappears. The woman can see and hear doctors, but does not feel pain.

When choosing between epidural or general anesthesia for caesarean section, it is worth considering the indications and contraindications for anesthesia.

Indications for such anesthesia

Most often, epidural anesthesia is used:

If labor begins ahead of time, for example, at 36-37 weeks. This anesthesia relaxes the pelvic muscles, and the baby’s head does not experience as much stress as it moves through the birth canal.
Severe hypertension.
when different parts of the uterus contract at different rates. Epidural anesthesia reduces the intensity of the contraction.
During prolonged labor, when there is no complete relaxation for a long time. This can lead to birth abnormalities, so epidural anesthesia is used to help the woman gain strength.

Contraindications

In addition to the indications, in the case of cesarean section there are also contraindications for such anesthesia, these include:

The presence of an inflammatory process at the puncture site.
Infectious diseases.
Allergic reaction to drugs.
If there is a scar on the uterus.
If the child is located transversely or takes an oblique position.
Narrow pelvis of a woman in labor.
Large baby weight.
If the woman herself does not want this type of anesthesia, then doctors cannot use it against her will.

Before using epidural anesthesia, the consequences, disadvantages and advantages must be considered.

Benefits of epidural anesthesia for caesarean section

The advantages of this type of pain relief include:

The woman remains conscious throughout the operation; there is no risk of intubation or aspiration.
There is no irritation of the upper respiratory tract, as with general anesthesia, which is especially preferable for patients with asthma.
The cardiovascular system works stably, since the drug acts gradually.
The relative ability to perform movements is preserved.
With this anesthesia, you can increase the time of pain relief, since the anesthetic is injected through the catheter at any time.
After surgery, opioid medications may be given to relieve pain.

In addition to the advantages, it is necessary to note the disadvantages of such anesthesia.

Disadvantages of epidural anesthesia

Any method of surgical intervention, as well as anesthesia, has its drawbacks. The disadvantages of epidural pain relief include:

An anesthesiologist made a mistake when administering the drug when the medicine gets inside the vessel. This can lead to seizures and a sharp decrease in blood pressure.
There is a danger of subarachnoid injection, as a result of which a total spinal block develops.
To perform such anesthesia, you must have good skills, since this anesthesia is the most difficult.
The drug begins to act only after 15-20 minutes, so surgery cannot begin immediately.
There is a risk of inadequate pain relief when the nerve endings are not completely blocked, and discomfort remains during the operation.
It is necessary to carefully select drugs for such anesthesia during cesarean section, as some can penetrate the placenta and cause disturbances in the breathing and heart rate of the fetus.
After the operation, you may feel back pain and headache.

To make the right choice if you are going to have an epidural or general anesthesia, you need to weigh the pros and cons. Take into account existing contraindications and choose the most suitable type of anesthesia.

Complications of epidural anesthesia

Epidural anesthesia rarely causes complications, although such cases do occur.

Most often noted:

In 1 out of 20 patients, the drug does not fully act, and the nerve endings are not completely blocked, which means that pain relief will be ineffective.
In the presence of coagulopathy, there is a risk of hematoma formation.
Accidental injury during puncture may result in leakage of cerebrospinal fluid into the epidural area. This can lead to headaches after surgery.
A large dose of pain medication may be toxic, resulting in an ineffective blockade.
There may be side effects from the use of specific pain medications.

From all of the above, we can conclude that epidurals have serious health consequences in very rare cases.

An anesthesia method such as epidural anesthesia is gaining increasing popularity; its consequences are minimal, but let's take a closer look. This type of pain relief is considered a relatively safe method. The effect of epidural anesthesia on the human body is much less harmful than when used.

Epidural anesthesia: side effects

Complications and side effects can arise from absolutely any drug, including.

This method of pain relief is carried out using a puncture in the back. Using a catheter, drugs are injected into the epidural space to relieve pain. Naturally, consequences are possible due to the proximity of the spinal cord to the injection site.

Typically the method is prescribed in the following cases:

During childbirth.
Operations on the genitals, legs.
For cosmetic procedures.
When reducing fractures.

Considering that with an epidural the patient is conscious, this method is more suitable. But patients are interested in a logical question: what are the complications of epidural anesthesia? After all, there are always risks.

Complications of epidural anesthesia

Unilateral action or complete absence. Alas, according to statistics, pain relief does not work for one person out of twenty.

Headache. They occur in 15% of patients. Usually they pass within 3-5 days, but there are cases when the duration increases to three months. This happens in case of accidental puncture of the dura mater.
Back pain. Occurs in every 3rd patient. It usually goes away in a couple of days.
If an epidural was used during childbirth, the baby and mother may have a fever. Medicine cannot yet answer why such a reaction to epidural anesthesia occurs.
Severe pressure drop. In case of hypotension, this method of pain relief is contraindicated.

These are the most serious side effects of epidural anesthesia. They can cause discomfort for a long time and develop into more serious complications.

Complications from epidural anesthesia may be milder and will subside quickly. These include:

Cough. It usually lasts a day and does not cause visible discomfort. This is one of the reasons why epidurals are not prescribed to asthmatics and patients with respiratory problems.
Sometimes the epidural injection site hurts. This is a natural process, the pain goes away after a couple of days.
Epidural hematoma. It can cause severe back pain that will last for a couple of weeks until the hematoma goes away.
Nausea and vomiting. Sometimes this happens if the drug is absorbed into the blood.
Spina bifida at the site of catheter insertion, but this complication does not occur immediately, but after a long period of time.
Sometimes hair falls out. But this effect more often occurs after childbirth with an epidural, and is more likely associated with the pregnancy itself, rather than the effect of the drugs.
Difficulty urinating.
Feeling of numbness in legs.

Many patients are afraid of this method due to the risk of such complications:

Paralysis. This effect is almost impossible with an epidural. It can occur during spinal anesthesia and occurs in one case in 250 thousand.
Coma. Such a complication is impossible after this method of pain relief.
High pressure. The epidural itself relieves blood pressure well, so it is ideal for hypertensive patients.

Can my legs swell after an epidural? This is possible if the patient has an allergic reaction to the administered drugs. Such swelling goes away in a couple of days. But swelling is rare, since before administering the main dose, the anesthesiologist checks the patient’s sensitivity.

Considering that the method is now actively used in childbirth, many women in labor are concerned about the consequences of epidural anesthesia in a few years. After all, every expectant mother makes sure that medications do not affect the baby’s health. The drugs will not have any effect on the baby. If the needle insertion is unsuccessful, a spina bifida may form at the injection site after a few years. Also, due to an error by the anesthesiologist, post-dural puncture syndrome is possible after epidural anesthesia, which is characterized by headache. It will go away in a couple of days.

Why is epidural anesthesia harmful to women in labor?

Increasingly, labor pain is relieved with an epidural. This method is also widely used. Women tolerate epidural anesthesia more easily; the consequences after the operation are minimal, both for the mother and for the child.

The expectant mother is constantly conscious and does not feel pain. She will hear the first cry, which is very important for her. The consequences of an epidural for women after a cesarean or natural birth come down to:

Prolonged headache.
Back pain.
Swelling in the legs, but sometimes they are simply associated with the birth itself.
Hematoma. It occurs more often in people with coagulopathy.

But compared to the pain of childbirth, such complications are not so terrible. And, if the patient has a question about which anesthesia to choose for a caesarean section - general or epidural, then the safest option would be an epidural. Even when compared with, an epidural is still better and causes fewer complications.

Conclusion

Anesthesia has been around for a very long time. Relatively recently, local anesthesia has been used, in which the patient remains conscious. This includes epidural anesthesia. But people are afraid of anything new at first, which is natural. And a rational question arises: why is epidural anesthesia dangerous during operations? The main risk is cardiac arrest, but this happens very, very rarely, and usually ends well. A strong decrease in blood pressure is also possible, so it is too risky to use such anesthesia for people with hypotension, but the method is perfect for hypertensive patients. There are short-term complications in the form of headache and back pain, pain at the injection site, cough, but they pass very quickly, usually in 2-3 days. If the needle insertion is unsuccessful, spina bifida may form several years after the use of anesthesia.

I created this project to tell you in simple language about anesthesia and anesthesia. If you received an answer to your question and the site was useful to you, I will be glad to receive support; it will help further develop the project and compensate for the costs of its maintenance.

Questions on the topic

Elena 03/12/2019 12:16

On February 26, 2019, an operation was performed with epidural anesthesia. I don’t know why, I weigh 48 kg, the anesthesiologist got to the right place only 4 times, I also felt like the needle was touching a nerve. In general, I lay in bed for 6 days after the operation due to a severe headache, squeezing like a vice. Citramon helped, but not for long. It was hard to raise my head. A week later everything went away. The girl from the next ward had the same reaction.

Many patients, when preparing for planned operations, are interested in what the consequences of epidural anesthesia during childbirth may be. After all, this method of pain relief is still little known to ordinary people.

The epidural space in humans is located along the spinal column. It envelops the hard protective sheath of the nerve roots and the spinal cord itself.

Epidural (peridural) anesthesia helps block the transmission of nerve impulses at the location of the nerve roots. As a result, a decrease in intensity or complete suppression of pain is achieved. The anesthetic is administered directly into the epidural area (space) using a specially designed catheter.

Such anesthesia is performed by administering various painkillers. This allows the procedure to be performed with varying degrees of effect.

Analgesia leads to loss of pain sensation. Anesthesia is necessary for complete loss of sensation. Muscle relaxation is performed to relax muscle tissue and reduce pain intensity.

Indications for epidural anesthesia during childbirth

Epidural anesthesia is a medical procedure that poses a certain degree of danger to the patient. Peridural anesthesia can cause side effects, has contraindications and is fraught with negative consequences. Only an experienced specialist should administer the drug.

First, a complete examination of the patient is carried out, a thorough examination of the anamnesis and laboratory test results. Based on the data obtained, the anesthesiologist and the specialist performing the primary treatment of the patient make a decision on the admissibility of the procedure in a particular case.

Such anesthesia is sometimes prescribed during obstetrics (especially during caesarean section), during urological and gynecological operations. Spinal anesthesia is also used for surgery in the lower extremities, perineum, and pelvic organs.

Drugs used

Involves the use of various drugs to achieve the desired effect. All injected solutions undergo intensive purification and are freed from preservatives. This increases their effectiveness and safety for the patient.

The main drugs for epidural anesthesia are local anesthetics:

bupivacaine;
lidocaine;
ropivacaine.

To intensify the analgesic effect, opiates are additionally used:

buprenorphine;
morphine;
promedol;
fentanyl.

In special cases, the following medications are added to the solution for epidural administration:

clonidine;
ketamine;
physostigmine.

The specific composition of the injected solution is determined strictly individually. Its dosage is selected at the rate of 1 or 2 ml of liquid per individual segment of the spinal cord that needs to be blocked. The defining moments are the clinical picture and the patient’s health status.

Contraindications to the procedure

The main contraindications to the use of epidural anesthesia are:

Possible consequences

Spinal epidural anesthesia causes various consequences that pose a danger to the patient's body. Some of them can be predicted in advance. Then it is better to refuse this type of pain relief. Some complications arise unexpectedly and for no apparent reason.

The degree of danger in a particular case is determined by factors such as:

age and general condition of the patient;
composition of the anesthetic solution;
correct procedure.

The main negative consequences of such anesthesia are:

Some consequences gradually disappear as the body is resuscitated postoperatively. Dangerous complications require special treatment.

Epidural anesthesia for caesarean section

Such anesthesia is increasingly used during obstetrics, relieving the young mother of the pain caused by the birth of a child. Epidural anesthesia for caesarean section, planned or emergency, is preferable to general anesthesia. The woman in labor remains fully conscious.

She can see her baby immediately after birth and hear his first cry. Therefore, many expectant mothers who are prescribed to give birth by caesarean section ask to replace general anesthesia with epidural anesthesia.

The final decision is made, of course, by specialists: obstetricians, anesthesiologists, pediatricians. After all, complications after epidural anesthesia are possible not only for the woman in labor, but also for the baby.

Consequences of epidural anesthesia during childbirth

If the required dose of anesthetic is exceeded, a woman in labor may experience:

toxic effects on the brain;
a sharp decrease in blood pressure;
development of convulsive syndrome;
respiratory disorder;
heart failure.

If the specialist administering the anesthetic is not highly qualified, the needle or catheter used during the procedure may injure the nerve roots of the spinal cord. If the required level of sterility is not observed around the injection site, infection and inflammation begin. Very often in such a situation, septic meningitis begins.

A sharp decrease in blood pressure causes general weakness, nausea, and vomiting. In this case, to stabilize the condition, it is enough to correct the pressure with the help of special medications.
If there is an error in administering the anesthetic, the dura mater of the spinal cord may be punctured. This causes severe post-puncture headaches and general weakness. Therefore, bed rest and absolute rest are prescribed for at least a day.

When a significant dose of anesthetic solution enters a blood vessel, severe intrasystemic intoxication occurs. Injury to the spinal cord roots leads to the development of severe pain in the back and spine. In this case, it is also possible to limit physical activity.

Epidural anesthesia during childbirth - consequences for the child

The results of special studies do not yet allow us to give an unambiguous answer to the question about the danger of epidural anesthesia for a child. The main factors that can cause negative consequences are:

It is reliably known that an epidural anesthetic administered to a young mother during natural childbirth noticeably reduces the child’s activity. This makes it difficult for him to be born and reduces the speed of passage of the fetus through the birth canal. In this case, there is a need to use vacuum extraction, forceps and other methods of assisting during childbirth. This can cause serious injury to the newborn.

If, after the administration of an anesthetic solution, a woman begins to tremble severely, the child experiences a significant lack of oxygen. In the future, the dangerous consequences of epidural anesthesia lead to various kinds of problems with breastfeeding.

Complications of epidural anesthesia during abdominal surgery

The use of epidural anesthesia during surgery is carried out to partially relieve pain in certain areas of the patient’s body, in addition to general anesthesia and to relieve postoperative pain. Anesthetics, opioids and other drugs used for anesthesia can have side effects on the patient's body. Specific complications in this case depend on the violation of the dosage, improper implementation of the procedure, and individual characteristics of the health status.

Many complications that appear after epidural pain relief go away over time without treatment or are easily eliminated with the help of medications. These include:

shiver;
itching and goosebumps all over the body;
drop in blood pressure;
partial or complete immobility;
back pain;
partial numbness or loss of sensation in case of damage to nerve fibers.

Serious problems are caused by a break in the catheter through which the anesthetic is administered. In this case, it is necessary to perform a special surgical intervention to remove the broken end stuck in the spinal canal.

An error when administering an epidural injection, leading to bone injury, subsequently causes severe pain in the spine and back. To eliminate them, a special course of treatment is required.

Headaches after epidural anesthesia can have a different threshold of intensity. If they occur as a side effect of the administered anesthetic, then they are easy to stop. Over time, the syndrome goes away. In the case when the epidural needle pierces the dura spinal cord, in order to relieve the patient of headaches, the puncture has to be repeated. When the accidental puncture is blocked, the pain will gradually go away.

Any convulsions and difficulties in performing natural functions (especially when urinating) can be eliminated by taking appropriate medications. Additionally, a course of physiotherapy and other healing procedures is prescribed.

Many people have to resort to the use of anesthetics. This is necessary during various surgical operations, as well as when severe pain occurs. There are several ways to relieve pain in the human body. This article will discuss how epidural anesthesia is performed. You will learn the pros and cons of this procedure, as well as the consequences.

All this information is simply necessary for a person who is about to undergo any kind of surgery or childbirth.

Anesthesia: general description and types

To begin with, it is worth saying that there are several ways to anesthetize the human body.

Anesthesia may be general. In this case, the patient falls into deep sleep and does not feel what is happening to him. A person regains consciousness only when the doctor completes all manipulations.

Local anesthesia is also available. It is used for easy and quick surgical interventions with minimal blood loss. During the procedure, the person is awake, but his mind is clouded and he does not feel pain. After the procedure, a person can clearly remember everything that happened to him. There are also cases when memory is completely absent. It all depends on the dose of the anesthetic and its type.

A more modern method of pain relief is epidural anesthesia. This procedure has more positive reviews than its predecessors. It is worth talking in more detail about this method of pain relief.

Epidural anesthesia

Reviews of such anesthesia have only positive ones. When the anesthetic is administered, attention is given to a specific part of the body. The patient is conscious during the operation and understands everything.

While general and local anesthesia are carried out by injecting medicine into the blood, epidural anesthesia affects the spinal cord. It is worth noting that the administration of the anesthetic should be carried out by a specialist who has experience in this matter.

This type of anesthesia can be used for various surgical interventions, but most often it is used during childbirth.

Pain relief process

Epidural anesthesia reviews are positive only if the pain relief process was carried out correctly. It is worth noting that this manipulation is very risky, as the spinal cord is affected.

Before inserting a needle into the back area, the doctor thoroughly disinfects the area. For this, various iodine and alcohol solutions are used. After this, the patient is asked to sit with her back to the anesthesiologist. The specialist feels the area he needs and begins to gradually insert a long catheter needle. The physician's goal is to enter the epidural space. Since the anesthetic cannot be injected anywhere, ordinary saline solution is used to check the correct location of the needle.

A syringe filled with sodium chloride solution is attached to the needle. The anesthesiologist slowly inserts the needle, trying to press the plunger at the same time. If the solution encounters resistance, it means the needle has not yet reached its target. As soon as the medicine begins to flow freely from the syringe, the needle is in the epidural space.

At this moment, a catheter containing an anesthetic is connected to the needle. The effect of the drug occurs almost immediately. Nerve impulses in the spinal cord are blocked, and the woman does not feel her lower extremities.

A similar method can be used to numb the upper abdomen, arms and head, but this anesthesia is rarely used. If surgery is necessary on the upper parts of the body, general anesthesia is often chosen.

C-section

It is worth noting that cesarean section under epidural anesthesia has only positive reviews. If a woman does not remember anything when using general anesthesia, then after an epidural she sees the process of the baby being born.

Each woman has the right to independently choose which method will be used to relieve pain in the body. If you are scheduled for a cesarean section, epidural anesthesia (reviews from women confirm this more than once) is the best option. Ladies note that they like to be conscious during such an important life event. It’s also nice that the baby is placed on the mother’s chest immediately after birth. This is exactly what is customary to do during natural childbirth.

It is worth noting once again that cesarean with epidural anesthesia has only positive reviews. When using this method, the woman does not feel the lower part of the abdominal cavity. In cases where general anesthesia is used, many representatives of the fair sex complain that the anesthesia was not strong enough and they felt pain during the operation.

After surgery, the catheter may remain in the epidural space for a long time. If complications arise during childbirth by cesarean section, the doctor may allow the woman to remain under anesthetic for several more days. This cannot be allowed when using general anesthesia.

Natural birth with epidural anesthesia

This procedure also has only positive reviews. It is worth noting that not all women use this method of pain relief. But if you expressed such a desire during the contractions, then you have no right to refuse.

Also, indications for the use of this anesthesia are high blood pressure, young age, multiple pregnancies and a low pain threshold.

During childbirth, epidural anesthesia (reviews indicate this) is not used immediately. At first, the woman in labor feels all the contractions, and only when severe pain begins is an anesthetic used. If the dilation of the cervix occurs rapidly, then the doctor denies the expectant mother such anesthesia.

Positive reviews about epidural anesthesia

There are significantly more good reviews about this procedure than bad ones. If you will soon be using anesthetics, then you need to learn more about the manipulation.

No influence on the child

During general anesthesia of the body, part of the anesthetic enters the child's body through the mother's blood. This is a big disadvantage of this type of anesthesia.

During epidural anesthesia, the drug does not reach the baby, since it enters the mother’s body not through the blood, but through the spinal cord. This is a definite advantage of this anesthesia.

Loss of sensation and consciousness

Another advantage that women in labor talk about is the complete loss of pain, but at the same time maintaining consciousness and memory. You can see your baby being born, hear his first cry. In this case, the lower part of the body will be completely anesthetized.

Opportunity to establish breastfeeding

If after general anesthesia doctors forbid a woman in labor to breastfeed for some time, then with epidural anesthesia this is possible. Due to the fact that the medicine does not enter the blood, its effect stops exactly the second the catheter is removed. Immediately after this, the baby can be placed on your breast.

The only exceptions are those cases when a caesarean section was performed and the patient requires a course of antibacterial therapy.

General positive effect on the body

In addition to the fact that this type of anesthesia blocks any pain, it also has a beneficial effect on the female body. The anesthetic reduces the level of adrenaline in the blood. The birth process is improving, the woman in labor behaves more calmly and confidently.

Also, the drug that enters the epidural area can slightly reduce blood pressure. Due to this, the vessels do not expand, but are in normal condition. This is one of the important points why epidural anesthesia has good reviews. Varicose veins after childbirth are unlikely if the blood vessels are in normal condition. This cannot be said about childbirth, which takes place without any pain relief.

Complications of anesthesia and consequences

Complications of epidural anesthesia are not very common, but they do occur. That is why, when agreeing to such anesthesia, you need to know all its disadvantages. Epidural anesthesia during childbirth can have very different consequences. Some of them are completely invisible and do not affect the quality of life in any way, while others are very dangerous.

Disability

The most terrible consequences after epidural anesthesia are damage to the spinal cord and all nerve endings. This phenomenon occurs extremely rarely, but no one is immune from it. You do not know how the spinal roots may be affected by the action of a particular anesthetic. It is possible that pain will be blocked for the rest of your life, and you will never be able to feel your lower body again. In this case, the person remains disabled.

Headache

Headaches after an epidural are very common. They arise due to the fact that during a puncture the needle damages the bubble of cerebrospinal fluid. Some of this composition leaks out and causes pain in the head.

Such impulses can also occur due to the use of an inappropriate anesthetic. Such complications of epidural anesthesia disappear within one month, and the woman happily forgets about them.

Backache

Epidural anesthesia during childbirth may cause discomfort in the back. If the puncture was initially done incorrectly or the substance was not injected where it was intended, then the woman may subsequently experience back pain.

These sensations are very different from muscle pain. They are more like so-called lumbago. If a woman turns to doctors with such complaints, she is prescribed painkillers that are allowed during breastfeeding. Back pain after epidural anesthesia goes away within one to two weeks.

Reduced blood pressure during childbirth

Epidural anesthesia (reviews from doctors in this sense are unanimous) can greatly reduce the blood pressure of a woman in labor. If it becomes very low, the expectant mother will not be able to give birth on her own. She simply does not have enough strength during pushing.

That is why during natural childbirth doctors use a small amount of anesthetic and inject it temporarily.

Prolongation of labor time

What consequences can epidural anesthesia have?

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Every fifth woman in labor in Russia uses this type of pain relief, and in European countries 50% of women resort to it. Epidural anesthesia during childbirth (back puncture) is performed exclusively before the start of pushing, during painful contractions, since its function is to block pain, leaving the woman conscious. Despite the effectiveness of this method of pain relief, an epidural is a serious medical intervention that has contraindications and can lead to serious complications.

What is epidural anesthesia

In the lumbar spine, between the outer wall of the spinal canal and the hard shell of the spinal cord, spinal roots pass, to which nerve impulses are transmitted from the pelvic organs, including the uterus. The introduction of an anesthetic blocks this process, due to which the pain sensitivity of the woman in labor is greatly reduced. Epidural anesthesia allows the woman to remain conscious; the doses of anesthetics are calculated so that the patient does not feel anything below the waist, but retains the ability to move. The period of pushing and childbirth passes without pain relief.

Effect on the fetus

Most experts believe that epidural pain relief used during childbirth does not affect the baby’s condition in any way. Injected anesthetics block nerve impulses, but do not enter the bloodstream and do not penetrate the placenta to the baby. However, if we take into account the fact that the baby during childbirth is exposed to no less stress than the mother and also experiences pain, then the use of pain relief for a woman is extremely undesirable.

The recommended refusal of anesthesia is due to the fact that pain provokes the production of endorphin in the woman’s body (the baby’s body cannot produce it), after which the substance reaches the child. If the mother does not need the pleasure/happiness hormone, the body does not produce endorphin and the baby, who needs it during childbirth, is left without pain relief.

Pros and cons of the procedure

Childbirth with epidural anesthesia has its disadvantages and advantages. This method of pain relief, compared to natural childbirth, has the following advantages:

epidural anesthesia provides an opportunity to avoid painful contractions and make the birth process more comfortable for the woman;
reduces the risk of increased blood pressure in women in labor with hypertension;
With the help of an epidural, you can relax and even sleep if labor is too long.

Pain relief during childbirth has the following disadvantages:

sharply reduces blood pressure in hypotensive patients;
carries a risk of complications of varying severity;
The psycho-emotional connection between mother and child is lost.

Indications for epidural anesthesia during childbirth

Since the injection can lead to various complications and negative consequences, doctors try to do without it during childbirth. However, there are indications for which anesthetics are injected into the epidural space of the spine:

Premature pregnancy. The anesthesiologist injects an anesthetic to relax the mother's pelvic muscles, while the baby will experience less resistance as the baby passes through the birth canal.
Discoordination of labor. This condition occurs when contractions occur, but they do not bring the expected effect: the cervix does not dilate because the muscles contract incorrectly.
Blood pressure is off the charts above normal. With the help of epidural anesthesia, blood pressure is normalized.
Long painful labor.
The need for surgical intervention. Indications for this may include multiple pregnancies, a baby that is too large, or the inability to administer general anesthesia during a cesarean section.

How to do the procedure

Epidural anesthesia for natural childbirth is carried out by a specialist anesthesiologist before pushing begins. How the manipulation is carried out:

The woman is in a sitting position, slightly rounding her back, or lying on her side, bending her legs under her. This way the doctor gets maximum access to the spine. In this position, the patient is asked not to move: a completely static body reduces the risk of complications.
The injection area is thoroughly treated with an antiseptic solution.
Next, a needle is inserted subcutaneously, through which an anesthetic (lidocaine) enters the body, reducing the sensitivity of the skin and subcutaneous fat at the site of catheter insertion.
The needle is inserted into the spinal space until the epidural catheter reaches the dura mater. If a woman in labor feels an approaching contraction, she should definitely warn the anesthesiologist so that he stops (it is extremely important not to move during the procedure). You also need to notify a specialist if there are any changes in your health, be it numbness of the tongue, nausea, etc.
Through the catheter, the anesthetic enters the epidural space. The device remains in the back until the pain medication takes effect. In this case, the woman is allowed to move, but not abruptly.
The catheter is in the back of the woman in labor even during pushing, while the needle is removed and the remaining device is glued to the back with a plaster.
After delivery, the catheter is removed and the injection site is covered with adhesive tape. The woman should remain in a lying position for some time after this to minimize the risk of complications after epidural anesthesia.

Pain medications

In addition to the usual lidocaine, anesthesia during childbirth is carried out using many other medications. These include:

Trimekain. The anesthetic begins to act 15 minutes after the injection, and the effect lasts no longer than an hour. As a rule, Trimecaine is used together with anesthesia.
Dicaine. The drug begins to act after 20-30 minutes, while the duration of epidural anesthesia is about 3 hours. This time is enough for most operations, including caesarean section. When using Dicain, it is important to carefully select the dosage, since even a minimal excess can lead to intoxication of the body.
Chloroprocaine. The drug blocks nerve impulses during childbirth for an hour after administration. Its action begins 15 minutes after epidural anesthesia.
Bupivacaine. You can feel its effect after 10-15 minutes, while pain relief lasts 5 hours. An epidural anesthesia drug is often used to improve a woman's condition and facilitate labor because it moderately relaxes the muscles of the uterus without inhibiting labor.

Complications of epidural anesthesia

According to reviews, in addition to pain relief, epidural anesthesia improves the birth process, making the woman in labor feel more comfortable and confident. However, maternity hospital staff do not recommend giving an injection unless there is a compelling reason due to the risk of complications during pregnancy and labor. Possible negative consequences of epidural anesthesia:

Getting anesthetics into the blood. There are many veins located in the epidural space, which poses a threat for medications to enter the bloodstream. In such cases, the woman feels dizziness, weakness, nausea, numbness of the tongue and an unpleasant taste in the mouth.
Allergy. The worst outcome in this case is anaphylactic shock. To prevent such a reaction of the body to epidural anesthesia, the specialist first administers the minimum dose of the drug.
Difficulty breathing. A rare complication that occurs due to the action of the anesthetic on the nerves going to the muscles of the ribs.
Pain in the back, head. The symptom occurs as a result of puncture of the dura mater and the entry of a small amount of cerebrospinal fluid into the epidural space. The pain syndrome usually lasts for about a day after childbirth, but sometimes does not go away for months and is subject to drug treatment.
Severe decrease in blood pressure. This may result in vomiting, spots before the eyes, and nausea. A dropper placed after the puncture helps prevent complications of epidural anesthesia.
Decreased bladder muscle tone. The complication leads to difficulty urinating.
Paralysis of the lower extremities. It happens extremely rarely with an unsuccessful injection.