Regional Analgesia for Labor and Delivery
Spinal and or epidural analgesia are the most common methods used by anesthesiologists to provide labor analgesia. These regional anesthetic techniques enable the women in labor to experience a RELATIVELY comfortable delivery without undo sedation. Depending on the stage and pattern of your labor, your anesthesiologist may choose to use either a "walking epidural", spinal or epidural technique.
The "Walking Epidural"
Well publicized in the media, the term "walking epidural" can be misleading. As regional anesthetic techniques for labor improve, the anesthesiologist is now able to provide relief of pain without the numb legs that were previously associated with epidurals. At Winthrop, the anesthesiologist actually is using a combination of a spinal and a epidural together, known as a CSE.This is a type of "walking epidural". With this technique the anesthesiologist can use two types of medications to reduce the chance of adverse effects that were associated with the use of higher doses of a single agent.
Complications of Regional Analgesia for Labor and Delivery
Any procedure carries with it a certain degree of risks. The most common adverse effect of regional anesthesia include backache and headache. If these occur they are usually self-limiting and will resolve in a few days. Severe headaches may require treatment. The other adverse but expected effects is itching that occurs following the CSE. This may last up to 45 minutes but is not detrimental in any way and is not an allergic reaction. Some of the other, but far less common side effects include infection, bleeding, seizures, fall in blood pressure, transient paralysis, nerve injury and drop in fetal heart rate. To reduce the risk of dropping the fetal heart rate your anesthesiologist may request that you receive sufficient intravenous fluid prior to initiating a regional anesthetic.
Anesthetic Choices for Caesarian Section
To reduce the risk of aspiration and enable to mother to be awake for the birth of their child, the preferred anesthetic is either a spinal or epidural. For women who are not in labor, spinal anesthesia is usually used. If a woman has labored with an epidural in place the epidural will usually be used to provide anesthesia for surgery. In certain instances general anesthesia may be necessary. Complications related to regional anesthesia for caesarian section are similar to those noted for labor and delivery.
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