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Epidural Anaesthetic
During this procedure, the patient either lies on her side with her
knees curled up towards the abdomen, or she is placed in a sitting
position, leaning slightly forward.
The anaesthetist begins the procedure by injecting a small amount of
local anaesthetic into the skin of the back, and this is probably
the only discomfort the patient will experience. A spinal needle is
then inserted, and once in position a very thin plastic catheter is
threaded through this needle and placed in the extra-dural space.
The needle is then removed, and the catheter strapped down against
the back.
During this time the patient may experience a few pins and needles,
or odd little pains traveling down the legs. She is then placed on
her side, and after a few minutes, rolled over onto the other side,
so that the anaesthetic can spread to both sides, blocking off pain
sensations.
Once this has taken effect the pain sensations in the lower half of
the body disappear, and where pain has been severe, the relief of
the epidural anaesthetic is dramatic - almost like turning off a
tap. Her legs will become heavy and lame, and a catheter is usually
inserted into the bladder so that she has no problem with urination.
Contractions are now only felt by the hardening of the abdominal
wall, and is unrelated to any sensation of pain. At times one side
of the abdomen will be less sensitive to the effects of the
anaesthetic than the other, and the patient may experience a little
discomfort on that particular side, this is very rare though.
Advantages:
- The beauty of this anaesthetic is that not only does it rid
the mother of any pain, making the birth a more relaxed experience
which will progress more efficiently, but it does offer the mother
the choice of being fully alert during a Caesar should she need
one. This will enhance the maternal bonding, giving the mother a
far better sense of achievement than the detached feeling that the
mother experiences on waking from a general anaesthetic.
- An epidural anaesthetic also carries far less risk than a
general anaesthetic would in the case of a Caesar.
- No other local anaesthetic will be necessary should the doctor
need to use forceps, vacuum extraction or in the case of an
Episiotomy.
- It can be allowed to wear off as you near delivery, giving you
the chance to control the actual birth, or alternatively topped up
if you feel it necessary.
Disadvantages:
- If your blood pressure drops, you may feel temporarily
light-headed and nauseous.
- Some women experience uncontrollable bouts of shivering during
the epidural.
- If a small amount of spinal fluid happens to leak out in the
process, it could cause violent headaches.
- An epidural takes about 20 minutes to administer, and it could
be quite difficult to remain absolutely still during this time,
especially if you are having contractions.
- Not all epidurals are effective.
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