What You Need to Know About An Epidural

Posted on 05/30/14 by Allied Anesthesia

Allied Anesthesia physician Dr. Thanh Tran specializes in labor and delivery at St. Joseph Hospital in Orange and spends a lot of time providing information about epidurals for his patients having their babies.

 Epidural Fast Facts:

An epidural is a procedure that numbs pain fibers and prevents transmission of pain signals to the brain.

The name ‘epidural’ comes from its place of delivery into the body, “the epidural space” which lies in front of the spine.

An epidural is a procedure, available to women in labor, that relieves pain and promotes more comfortable labor and delivery.

Unlike receiving systemic narcotics (IV pain medications), the effects of an epidural remain targeted to the area in need, without significantly affecting other areas of their body.

Effects are localized, so less medication is administered. This is safer for the baby and the mother.

Epidurals allow the mother to be awake, alert and comfortable during labor.

Communication During Any Procedure Is Key

To ensure patients are comfortable and at ease with their epidural, Dr. Tran likes to make certain all women’s questions are answered with clarity.

Is it safer than other options?

It’s a safer option. Because there are less drugs in the mother’s system and it’s safer for the mother and baby.

What if I need a C-section?

If a C-section is called for, the epidural can be used to prevent the need for general anesthesia.

What if I’m nervous?

Labor is a time of high anxiety; unfortunately, that anxiety causes an excess production of stress hormones in a mother, which can ultimately slow contractions. The epidural can help with those issues. It’s amazing how many times I’ve seen a labor that’s not progressing be facilitated by an epidural by alleviating pain and anxiety and allowing a patient to relax.

When is it too late for an epidural?

Women can usually receive an epidural at any point during labor, provided there is enough time for it to take effect before delivery.

What are the risks?

Though you should discuss the risks with your doctor, the risks are minor and rare.

There is an increased risk of assisted delivery (forceps or vacuum extraction for delivery).

The medication may decrease blood pressure. Your doctor will monitor your blood pressure and treat as necessary.

Headaches can occur if the needle is inserted through the epidural space into the dural area.

Fever can occur, but the increase in temperature is not believed to be from infectious causes.

Occasionally, an epidural does not work effectively and a woman may still feel pain, or pain on one side.

Meningitis is an inflammation of the membranes that cover the brain and spinal cord, which is a serious but treatable complication. The risk of meningitis is the most common of the “rare neurological complications” occurring in an estimated 1 out of 100,000 patients or at a rate of 0.001%.

Another rare complication is the accumulation of blood in the epidural space, which can cause neurological symptoms. This is a surgical emergency and is typically linked to the concurrent use of blood thinners (anticoagulants) – one of the reasons that women on blood thinners (anticoagulants) are typically not candidates for epidurals.

The development  of spinal epidural abscess after an epidural is extremely rare and estimated to occur in 1 out of 505,000 patients or at a rate of 0.0001%. This rare complication can be life-threatening and can present with signs of back pain, incontinence and neurological symptoms.

Women who are concerned about the epidural’s effects should talk to their anesthesiologist to get the facts.

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