May 24, 2020 0 Comments

The use of drugs in medical procedures for relieving or reducing pain is now a part of almost every medical process. Similarly, the labor and birth process (childbirth) is an agonizing experience where women often turn to pain relief drugs to be spared from the pain of it.

What Is Meant By Epidural?

Epidural is a popular drug administration method, where a combination of analgesic and anesthetic is injected in the epidural space (mid-back) near the spinal cord. It belongs to a group of local anesthetics, drugs that can reduce the pain but do not cause loss of sensation or complete numbness. Epidural is usually given combined with narcotics. The dosage of epidural anesthetic is administered by an anesthesiologist.

According to the National Center of Health Statistics, it is estimated that 50% - 60% of women in labor take epidural to ease the process of childbirth.

Two Basic Types of Epidural

1. Regular Epidural: commonly used in the United States, this includes injecting anesthetic pain relievers into the mid-back with a needle and then inserting a catheter to provide medication steadily.

2. CSE (Cerebrospinal Epidural): the needle is injected deeper, between the epidural space and spinal cord with a catheter attached. This provides pain relief for 4-8 hours.

Epidural is usually confused with Spinal Block while they differ in the insertion method and dosage and are not the same.

Epidural anesthetics provide partial blockage of pain, from the waist down. The anesthesia serves to hinder the pain signals that are carried by spinal nerves to the spinal cord. Pain relief is felt within 20-30 minutes later. A small dose of it would still provide movement in legs and lower body while no pain is felt. This also allows the mother to be awake and participate in experiencing childbirth. 

Studies showed that out of 100 women taking epidural only 1 required additional pain relief medication. On the other hand, 28 out of 100 women opted for pain relief when they weren't provided an epidural initially.

Epidural is considered beneficial, especially during childbirth where labor is of longer hours. It also reduces the fatigue and exhaustion of natural childbirth, making it a positive experience.

Adverse Effects

Pain Relievers can also pose secondary effects on the body. These complications include:

• Drop-In Blood Pressure: Epidural can disturb the regulation of blood in the body as a result of the anesthetics given. This might lower blood pressure. It is necessary to keep blood pressure in check and be provided with IV fluids to stabilize.

• Fever and Soreness: Using epidural anesthetics during childbirth increases the chances of getting a fever. Nausea and shivering are also common effects.

• Damaged Nerves: though it is a rarity, nerves can also be damaged by the needle inserted in the epidural space.

This can cause permanent or temporary loss of sensation waist down. According to the American Society of Anesthesia and Pain Medicine, the chances of nerve damage are from 1 in 4,000 to 1 in 20,000.

 

• Difficulty in Urinating: epidural also affect bladder muscles. The ability to know when your bladder is full comes back as the anesthetics wear off.

• Additional Assistance: epidural does not always help to ease childbirth completely. Sometimes, additional pain relief is still needed. Furthermore, the mother may have trouble delivering and the child may be delivered Cesarean section or by forceps.

 

• Other Rare Complications:
  

1. Epidural can also cause infection by the needle inserted.

2. It can also affect the respiratory system affecting breathing.

3. High dosage of epidural can also cause temporary or permanent paralysis.

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