Regional Anesthetics For Labor

Epidural Anesthetics are very popular because of the excellent pain relief that they provide. While they do not eliminate all sensation, epidural blocks greatly diminish the pain of contractions. The epidural can be placed anytime after you have been admitted and are in labor. When you request your epidural to be placed, your labor nurse will confirm with your obstetrician that this is an appropriate time for an epidural. Then, the anesthesiologist or the CRNA in consultation with the anesthesiologist, will perform a pertinent medical history and exam prior to placing your epidural. The epidural is administered in your lower back using a special needle. The needle is placed below the level of your spinal cord. Depending on the preference of the anesthesiologist you either will be sitting or on your side when the block is performed.

The anesthesiologist will wash off your back with antiseptic solution and will use a local anesthetic injection to numb your skin. The epidural needle will be placed in the epidural space just outside the sac that holds your spinal fluid. A tiny flexible tube is inserted through the needle. This tube will be left in place during your labor. Occasionally the tube will gently brush against a nerve and you will experience a brief tingling sensation similar to “hitting your funny bone”. Anesthetic solution, which bathes the nerves and blocks the pain, is continually administered through this tube.

It takes between 10 to 20 minutes for the epidural to take full effect. After that time your anesthesiologist will adjust the medications to the degree of numbness that meets your particular needs. The block will last as long as you need it. You may notice some temporary numbness or heaviness in your legs.

After delivery the epidural catheter will be removed and your normal sensation will return within a few hours.

What Are The Risks Of An Epidural ?

Complications or side effects can occur but are uncommon. Serious complications are very rare. At Riverside Hospital and Dublin Hospital over 7500 patients safely receive epidural anesthetics each year. Our anesthesiologists take special precautions to avoid any adverse effects. To prevent your blood pressure from dropping, you will be given IV fluids before the epidural is administered. After the epidural is placed, and until your baby is delivered, you will be positioned with your hips slightly tilted.

Shivering is common during labor and often occurs whether or not you receive an anesthetic. Warm blankets are available to help.

Although uncommon (1% or less), a headache may develop following a regional anesthetic. Sometimes this headache is called a spinal headache or post-dural puncture headache. This occurs if the needle nicks the sac that holds the spinal fluid. Your anesthesiologist will ask you to hold as still as possible during the placement of the needle to help decrease the likelihood of a headache. When it occurs, the headache may last a few days. There are several effective types of treatment available should you have a headache. If this nick occurs it is known by your anesthesia team and they will let you know that a spinal headache is possible.

Since the blood vessels in the epidural space become swollen during pregnancy, your anesthesiologist will administer a test dose to make sure the epidural tubing is not within a vessel. After the test dose you will be asked if you notice any dizziness, a funny taste in your mouth, or a rapid heartbeat.

Some situations do arise during labor after your epidural is placed that warrants the need to adjust the epidural tube or replace the epidural.      

Other types of regional anesthesia are available during labor. Your anesthesiologist, obstetrician, and you will decide which type of anesthesia best fits your particular situation.