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EPIDURAL ANESTHESIA

Epidural is a kind of anesthetic, or medication, to stop pain. It is commonly used during labor and delivery because it numbs your lower body while allowing you to remain awake. During an epidural, anesthetic is injected into the area around your lower spine. Within minutes, your body becomes partly numb from about the waist down. You may lose muscle control in your legs, but you can still usually push during contractions. Little, if any, anesthetic reaches your baby. An epidural can be used for both a vaginal delivery and cesarean section. An anesthesiologist starts the epidural and monitors you throughout your labor and delivery. He or she will talk to you beforehand about the anesthetic and what to expect.

 
An epidural is usually not administered until you are in active labor (about 4 cm dilated). You’ll be asked to sit on the edge of the bed with a pillow in your lap, and lean your head forward. First a small area on your back around your lower spine is cleansed sterilely, and then numbed with a local anesthetic. The anesthesiologist then inserts a needle into the epidural space. A tiny plastic tube (catheter) is threaded through the needle. The needle is removed and the medication is given through the catheter. Sometimes a pump is attached to the catheter. The pump gives you a constant level of anesthetic throughout labor and delivery. During this time, your blood pressure and heart rate and your baby’s heart rate are closely watched.
 
There are some risks and complications associated with epidural use. These are usually self-limiting problems which can be easily handled. You may experience a sudden drop in blood pressure, most usually occurring immediately after receiving the epidural. This may slow the baby’s heartbeat for a short time. This is usually handled by increasing the amount of intravenous fluids, repositioning the mother to increase blood flow to the uterus. You may be given an oxygen mask for a short while. Sometimes the epidural will make the contraction pattern slow down, and you may need pitocin infused to help get labor reinitiated.   Other rarer complications include severe headache and very rarely, dizziness, seizures and allergic reaction to the anesthetic, nerve damage, or paralysis. Again, these are very rare events.
 
Shortly after delivery, the epidural catheter is removed. You’ll need to rest in bed until the anesthetic has worn off and you have normal feeling in your legs again. This may take up to 2-4 hours. Until you have fully regained use of your muscles, you may need a catheter in your bladder.




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