30 мая 2024
Epidural Anesthesia: Weighing the Benefits and Drawbacks


30 мая 2024
Epidural Anesthesia: Weighing the Benefits and Drawbacks
## How does it work?
During epidural anesthesia, a local anesthetic is injected through a catheter into the epidural space between the spinal cord sheaths inside the spinal canal. The drug affects the nerve endings, temporarily disabling their sensitivity and relaxing the muscles. The patient remains conscious, but does not feel pain in the part of the body where the anesthesia is administered. The effect occurs after 10-20 minutes and can last from 30 minutes to 12-24 hours. This method of anesthesia has a number of advantages including:
- High degree of anesthesia
- Minimal risk of complications
- Preservation of consciousness
- The ability to adjust the dosage, time of action and type of drug
## Where is it used?
Most often epidural anesthesia is used in obstetrics for cesarean section births and painful contractions. During labor, the dose of anesthetic is reduced or discontinued so as not to weaken the labor activity. Epidural anesthesia is also used during urological, inguinal, abdominal and thoracic surgeries, in orthopedic practice, in vascular surgeries on the legs and in procedures involving the chest, neck and arms.
> Like other types of anesthesia, there may be residual effects after epidural anesthesia including temporary urinary incontinence or difficulty urinating, back pain, itchy skin or hematoma in the area of the catheter, headaches, and dizziness.
## Is it harmful to the baby?
This is the most frequent question that future moms ask, and therefore it is carefully studied by scientists. Previously, ===it was believed that epidural anesthesia during contractions can cause the need for cesarean section, because in the womb the baby becomes lethargic. However, experience has proven that administering anesthesia early in labor reduces this likelihood. Serious complications caused by epidural anesthesia are extremely rare. Nevertheless, the following short-term side effects occur in babies born with the use of epidural anesthesia:
- Decreased heart rate and respiratory rate
- Drowsiness
- Decreased muscle tone and problems with breast engorgement during feeding
## Are there contraindications?
Epidural anesthesia is considered safe, but there are a number of circumstances in which it is not performed:
- Labor progressing too quickly
- Skin diseases and inflammatory processes at the catheter site
- Spinal deformities, rheumatic diseases
- Diseases of the nervous system, hypotension
- Intestinal obstruction
- Allergy to local anesthetics
- Shock state received during trauma
- Blood coagulation disorders (hypocoagulation)
- Pathologies of the cardiovascular system
> In rare cases, anesthesia does not work. The reason may be individual characteristics of the body or narrowed spaces between the vertebrae where the needle can not pass. The success of the procedure depends on the skill of the anesthesiologist and how carefully he or she paid attention to the patient's history.