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Epidural Analgesia

Thursday, August 23rd 2012. | Pregnancy

Epidural Analgesia Definition

It is a technique of regional anesthesia is practiced by the anesthesiologist.

The purpose of this type of anesthesia is to reduce and eliminate pain throughout the lower part of your body, while fully aware of your birth.

The principle of the APD is to introduce a thin tube called a catheter, within the space around the spinal cord and nerve roots (epidural space), and to inject an anesthetic solution to block the transmission nerve pain.

One of the advantages of this technique is to inject the anesthetic catheter when the patient feels pain again.

Epidural Analgesia

Epidural Analgesia (img thanks to methodsofhealing.com)

How is it t?

Epidural anesthesia follows a well-defined protocol which will be presented by the anesthesiologist.

Information on ODA is delivered in consultation with the anesthetist.

To achieve an ODA, the patient can be positioned in two ways:

  • Is in a sitting position with the back “round” to facilitate movement,
  • Is in position “curled”, ie lying on its side.

The anesthetist prior realizes disinfection of the skin over the area of interest. A first injection is carried out in the back, facing the spine in the lumbar region (lower region). This superficial injection is intended to anesthetize the skin and subcutaneous tissue to facilitate the introduction of epidural catheter.

The second shot is made by means of a needle for introduction of the catheter within the epidural space, and thereby inject the anesthetic, and that, throughout the delivery if the patient feels back pain.

The catheter is fixed by a bandage, and remains in place throughout the delivery. It is removed before the lift is in the room or the next day depending on the case.

In general, the placement of the ODA is not painful, but it may possibly be uncomfortable. You can feel the bite of the needles or possibly “electricity” in the path of one of the legs.

In general, less than fifteen minutes after the injection, the uterine contractions are more painful (but are still felt).

For Caesarean Section?

For caesarean section is not necessary to anesthesia.

Dural anesthesia perished in place, it is sufficient simply to inject the anesthetic solution.

Please note however, that ODA may be insufficient, and in these cases (relatively rare), it is always possible to quickly relieve the patient to achieve a general anesthesia for caesarean section.

What level of obligation?

The epidural is not mandatory

If you want to give birth without epidural anesthesia, it is quite possible. You should talk to the team that will welcome you (and if possible during prenatal consultations).

It will strive to relieve you by other means and support you in your endeavor.

If you can not stand the pain, you can at any time request that we make you eligible for ODA (provided you do not take it too late, because it takes several minutes before being effective.)

What cons-indications?

There are indications against ODA.

Against these indications will be sought during the consultation you will have with the anesthetist during the 8th month. For example, some patients with bleeding disorders or who took antiplatelet agents such as aspirin will not be eligible for ODA.

In addition, bone lesions of the spine or dermatological diseases at the bottom of the lumbar region can make ODA impossible. Tattoos are not a cons-indication but requires special precautions.

What are the risks?

The risks are very limited.

Side effects are overwhelmingly benign. For example, a feeling of heavy legs, pain persisting at the point of puncture, hypotension phenomena are most frequent.

However, there is an entity which is fairly typical of the wound dura which can cause major headaches in the days following birth. This syndrome is known, it is quickly covered by anesthetists.

Serious adverse effects, including neurological, are exceptional.

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