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Epidural anesthesia during labor – Fear of side effects

What is epidural anesthesia?

The most popular method of pain relief during labor is epidural anesthesia. More than 50% of women use epidural anesthesia due to giving birth. Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body. Epidurals block the nerve impulses from the lower spinal segments, which results in decreased sensation in the lower part of the body and allows you to remain awake during the delivery. Epidural anesthesia can be used for either a C-section or a vaginal birth.

How an epidural is given

Epidural anesthesia involves the insertion of a sterile guide needle and epidural catheter into the epidural space (space between the spinal cord and outer membrane of the spinal cord. Before the guide needle is inserted an anesthesia specialist uses a local anesthetic to numb the area where the needle will be inserted. The catheter remains in place, while the needle is removed.

The whole process is about 10 minutes long. First the anesthesiologist will ask you to sit up or lie on your side, keeping the lower part of your back curved towards him. The nurse will help you to get in the correct position. If you have contraction the doctor will wait until they pass, because you will be ask not to move at all during some parts of the procedure. Then as we described, the anesthesiologist will numb your skin with a local anesthetic and will insert the catheter. The epidural catheter is secured in a place with adhesive and bandage, and stays in place for the duration of labor.

Does it hurt? Compared with the pain of contractions, placement of epidural is almost with minimal discomfort.

Epidural medications

For epidural anesthesia are used local anesthetics, such as bupivacaine, chloroprocaine, or lidocaine. They are often given in combination with narcotics such as fentanyl and sufentanyl in order to decrease the required dose of local anesthetic.

Women are often afraid of side effects of epidural anesthesia. You should know that epidural anesthesia is usually safe. However, side effects and complications can sometimes occur. Common side effects are:

Slowing on labor

If epidural is given for vaginal birth can often slow a woman’s labor. This slowing is related to the effect of the epidural on a woman’s pelvic muscles. These muscles guide the baby’s head so that it enters the birth canal in the best position.

Low blood pressure

The most common side effect associated with having an epidural is hypotension or low blood pressure. The local anesthetic affects the nerves that go to your blood vessels, leading to a fall in blood pressure. There is no need to worry. During labor, your blood pressure will be closely monitored and if necessary can be given medication to treat low blood pressure.

Loss of bladder control

As well as numbing the uterus, an epidural will numb the bladder. You will not be able to feel when your bladder is full and not be able to pass the urine, in which case you will be catheterized. A catheter inserted into your bladder allows urine to drain away.

Headaches

Headache can occur after delivery in 2-3% of mothers, due to unplanned puncture of the lining containing spinal fluid. This headache, known as post-dural puncture headache can be moderate to severe, but is not permanent or life-threatening. Specific treatment is available for severe headaches. 

Back pain

There are no evidence that epidurals cause chronic back pain, but may occur some back tenderness at the site of insertion. But if you experience severe back pain after epidural, you should let the doctors investigate the problem.

Itching

Pain killers in combination with anesthetic can cause itchiness, which can be easily treated. 

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