Epidural anesthesia is a regional anesthesia. It blocks pain in a particular  region of the body. The aim  is to provide pair relief rather than anesthesia which leads to   total lack of feeling. Epidural  block nerve impulses from the lower spinal segment. This results in decreased  sensation at the lower half of the body. The  medicine is delivered through a catheter that is inserted into the spinal space just outside the membrane that surrounds your spinal cord and spinal fluid. It is the most common method for pain relief during labor.

How is an epidural given ?

Intravenous fluid IV is started before active labor begins and before placing the epidural. An anesthesiologist, obstetrician or nurse anesthetist  will administer the epidural.

You will be asked to arch your back and remain still while lying on your left side or sitting. This  position is vital for preventing  problems and increasing the effectiveness of the epidural.

The waistline area of your mid back is wiped with an antiseptic solution to reduce the risk of infection. A needle with local anesthesia is injected into a small area on your back to numb it. A needle is then inserted into the numbed area surrounding the spinal cord in the lower back.

A catheter is then threaded through the needle into the epidural space. The needle is carefully removed , leaving the catheter in place to provide periodic injections or continuous infusions. The catheter is taped to the back to prevent it from slipping off.

What are the benefits of an epidural ?

Some of the benefits include the following :

• allows you to rest if labor is prolonged
• you remain alert  and can take active part in the delivery of your child
• reduces the discomfort of childbirth
• during a cesarean delivery, an epidural allows you to stay awake and also provides  effective pain relief during recovery
• it will help you  deal with exhaustion, fatigue and irritability  when other coping mechanisms are not working. It can also help you relax, get focused and give you strength to take active part in childbirth

What risks are associated with an epidural ?

Some of the risks you may encounter include the following :

• They can cause blood pressure to suddenly drop . If this occurs, you will be treated with IV , oxygen and medications
• you may get severe headaches as a result of leakage from spinal fluid. A procedure known as blood patch may be performed if symptom persist. During this procedure, your blood will be injected into the epidural space to relief headache
• you may experience side effects such as shivering, nausea, backache, difficulty urinating, ringing in the ears and soreness at the sight of injection
• you will need to alternate sides in bed after the epidural is placed. You will also be monitored for fetal heart rate. Lying in one position can cause labor to slow down or stop
• epidural also makes pushing more difficult. You may need medical intervention such as the use of forceps or a cesarean.
• there may be permanent nerve damage at the site of injection of the needle. However this is rare.
• most research indicate that babies may have trouble latching on during breastfeeding. The baby may also experience respiratory depression, increase in fetal heart rate variability , fetal malpositioning  thus increasing the need for forceps , vacuum and cesarean delivery.

NOTE

Not all women are candidates for an epidural. Women who fall in the following  category may not be given an epidural. Women with

• low blood pressure
• bleeding disorder
• a skin  infection on the lower back where the needle will enter the skin
• not at least 4 cm dilated
• a doctor cannot locate the epidural space
• blood infection
• if you’ve had a previous reaction to local anesthesia
• women taking specific blood thinning  medications
• if labor is moving too fast and there is not enough time to administer epidural