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What is Epidural Block?
The
epidural block is possibly the most effective and popular
method of pain relief. In the United States alone, it is
used by more than half of all laboring women. The epidural
involves an injection given near the nerves in the lower
back, thus numbing the lower body.
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Effects of Epidural Block
The
epidural mainly blocks pain from contractions and at the
same time, it allows the patient to be awake and alert. The
epidural can also be used for a
cesarean delivery
and it usually has very little or even no effect on the
baby.
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Candidates for Epidural Block
The
epidural is for women who need regional anesthesia for labor
and birth.
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Your
Consultation
Prior to
the injection, the doctor will cleanse your lower back with
an antiseptic and then apply a local anesthetic to numb the
area.
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The Epidural Block
Procedure
First,
you will be asked to sit or lie down on your side with your
back curved outward. The doctor will insert the needle and
then pass a small flexible tube called a catheter through
it. It is likely that you would feel some pressure as the
needle is inserted, but it should not be that painful. The
doctor will then remove the needle, leaving the catheter in
place so you can be given additional medication as needed,
without needing another injection.
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Recovery
After
about 5 to 15 minutes, you should begin to feel some pain
relief, though you may still feel some pressure during
contractions. It is possible that you might not be able to
walk around once the epidural takes effect, but you should
be able to push during the delivery.
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Risks
The
epidural has a few disadvantages. Some women experience a
drop in blood pressure that can temporarily slow down the
baby's heart rate. Your doctor will provide you extra fluids
through a vein and may have you lie on your side in case
this happens. There are also some women who experience mild
itching, shivering or a fever. If this occurs, the doctor
may want to test the baby for infection and then treat with
antibiotics. Serious side effects in the mother are rare but
could include severe
headache that can last for days or weeks, breathing
problems, dizziness and also seizures.
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Frequently Asked
Questions
Q: Who
administers an epidural?
A:
An epidural is usually given by either an
anesthesiologist (a doctor specializing in pain relief) or a
nurse anesthetist (a registered nurse who has special
training in pain relief).
Q: Are
there drawbacks to getting an epidural?
A:
The
epidural can greatly affect the course of your labor and
delivery. Sometimes though, it results in more medical
procedures. Women who get an epidural are likely to have
longer labors and more vaginal deliveries where the doctor
uses instruments to help the baby out. Since an epidural
sometimes slows contractions, you may probably receive
oxytocin, another drug that is given intravenously, to speed
them up. But an epidural may also help relax women who are
especially anxious or tense, thus aiding the contractions to
pick up. It is also possible that an epidural can make it
difficult to urinate so you may need a catheter to drain
your bladder. The use of other drugs and IV fluids and
frequent electronic fetal monitoring are also common with an
epidural.
Q:
What happens during the procedure?
A:
First, a needle is inserted into the epidural space that is
just outside the spinal canal and then a catheter will be
passed through it. After that, the needle is removed and the
catheter stays in your back throughout your entire labor and
until after the birth of your baby. Continuous medications
will be given through the catheter to help keep you
comfortable by numbing a narrow area of your lower abdomen.
If necessary, the block may be extended to include your
peritoneum.
Q: How
will I feel during the procedure?
A:
A lot
of people describe the procedure as slightly uncomfortable.
You may experience some pressure or cramping and
occasionally feel a small "shock" sensation. Those who have
had two or more back surgeries in the area may feel more
discomfort because of the presence of scar tissue. You will
be wide awake during the procedure, though the doctor may
provide you sedation before the procedure.
Q: Are
there restrictions afterwards?
A:
It is not
advisable that you drive yourself home since the medicines
used can cause drowsiness, slow response and reduced
coordination. But other than that, you are free to eat,
drink, or move normally, although it is recommended that you
take it easy for the rest of the day. Also, avoid heavy
lifting or excessive bending, twisting, pushing, and
pulling, until all of your blocks are completed.
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