Anesthesia during labor

Epidural anesthesia advantages and risks

Anesthesia during labor

Dr. D. Rafael de Retes , Anesthesiologist at the La Paz University Hospital in Madrid.

Not many years ago giving birth was synonymous with suffering due to the great pain that the mother suffered during childbirth. Epidural anesthesia has managed to almost completely eliminate the sufferings of pregnant women , although there are still future mothers who are afraid of this type of anesthesia, especially due to ignorance.

The epidural is the best method for childbirth: its great advantage is that it practically eliminates pain

The epidural consists of providing a different amount, depending on the patient, of local anesthetic mixed with a little morphic in a virtual space between the dura mater and the ligaments of the spine . The spinal column goes from the outside to the inside: there is the skin, some ligaments, fat, and then there is a ligament called the yellow ligament, which is practically attached to the dura mater. The tough mother is the meninges, which covers the spinal cord. The anesthetic must be placed right in the epidural space , the space before the dura.

In anesthesia there are still many techniques that are not precise; therefore, everything consists of the hand, which is guided by a series of signs, because the epidural or epidural space is a place where there is negative pressure. In fact, puncturing the yellow ligament, resistance to the needle is noted.

The needle to locate the space is the same as the one used later to put the catheter or directly the dose, but the syringe is different. The syringe that is used to locate the space is called low resistance, with which the doctor feels much easier to touch, the yellow ligament is much harder, and as soon as it is slowly removed, a tremendous ease is perceived. There is a negative pressure that pulls the doctor. That is the place where you have to put the anesthesia. First you put a test dose , because it is dangerous to put it directly.


When is anesthesia necessary?

Currently, in the times we live in, it is essential . Childbirth is an obstetric difficulty and requires some type of anesthesia. Nowadays it is very rare to give birth without epidural anesthesia , unless the woman, for whatever reasons, does not want to and refuses, unless there is a technical difficulty, or some difficulty related to the woman and not it can be put on. Women who give birth are generally young and have very few problems.


Why do women refuse?

Normally they refuse because they are afraid, or because they want to know what a real mother feels, suffer the pain and then be able to tell it.


Types of anesthesia in pregnancy

An epidural is the best method of delivery . If, for example, a woman arrives at a hospital giving birth and is ready, a spinal anesthesia is usually performed, because the woman’s collaboration is no longer needed to finish the delivery. That happens in very few cases. The normal thing is to put it in the period of dilation .


Necessary material

Currently all the equipment is presented in perfect condition. In the past, hospitals had to cook the needles themselves to sterilize them. Now it is presented in sterile cases that contain an epidural needle , which is the one with which it is injected, and a series of needles to load the anesthetic. The epidural needle is called a Tuohy needle.

The equipment also has normal hypodermic needles to load the anesthetic. Keep in mind that what bothers the most is the skin. If you anesthetize with a very fine needle, you make a local anesthetic skin soap , and you already have a hard time. Then you have a catheter , which is the one that is inserted through the epidural needle and is held with a special clamping mechanism. Normally, at that point what is done is to plug in an infusion pump where the mixed dose of anesthetic goes.


Risks of an epidural

The most important thing is to tell the patient’s medical history to verify that he or she can be a healthy person, who does not have spinal problems or blood clotting disorders, because if not, an epidural hematoma could be made by puncturing .

Most often, the hard drive is uncomfortable. The epidural needle is a thick needle. If the doctor goes over and appears within the encephalo-spinal space, then a fluid leakage and a fistula occur . Many times with rest and a good infusion of liquids is enough to correct this.


Advantages of an epidural

The great advantage of an epidural is that women give birth without any pain. They do not have to have the slightest discomfort. Even for a complicated delivery that ends in a cesarean section , the patient is already anesthetized, a slightly stronger dose is given with the same catheter and she can now deliver.


Preparation of the anesthetist


In all Social Security hospitals there is an anesthesia service to anesthetize any type of gynecological issue. All those doctors are the ones who do the epidural. So there is a team on duty, because in large hospitals there are many deliveries, especially with the arrival of immigrants.


Duration of the anesthesia process

It depends a lot on the dose given and the concentration. A local anesthetic concentration must be administered that is rather weak, because the patient has to collaborate by pushing, even if it does not hurt. If a high concentration is administered, it is useless, because the patient would not help. You have to reach a level without pain but that has mobility.

You May Also Like

More From Author

+ There are no comments

Add yours