Epidural Analgesia in Labor | Procedure And Side Effects

Labor is considered one of the most painful experiences. Pain relief is necessary for women in labor, yet the decision about whether to use an epidural is an individual one for you and your family. 

What is an Epidural Analgesia?

During childbirth, women are given a variety of pharmacological pain management treatments. It comprises nitrous gas inhalation, opioid administration, and local analgesia with an injection for a peripheral nerve block. Epidural analgesia is considered one of the effective and popular treatments for labor pain. The rate of side effects is low, exceptions are still there. 

Epidurals are used for pain management during childbirth and need the administration of a general anesthetic into the bottom part of the back near the pain-transmitting nerves. A bolus injection which is a large and rapid injection is used to administer epidural solutions or is administered utilizing continuous infusion or a patient-controlled pump. 

Depending on the health of the baby and your pregnancy and the specifics of your labor and childbirth, an epidural may not be an option for you. Understanding the pros and cons of it helps to decide whether to opt for it or not. According to some research, when modest dosages of local anesthetic were combined with an opioid, women were able to move around throughout labor and take part in the delivery of the baby. 

Another technique known as “combined-spinal-epidural” refers to a single local anesthetic injection or administering opiate into the cerebrospinal fluid for immediate pain treatment and an epidural catheter is also inserted for long-term pain control. There are a few side effects such as itching and sleepiness, trembling, and fever are reported in few women. Epidural analgesia can have rare but severe side effects, such as severe long-term neuralgia. 

Pros of Having an Epidural

  1. It is one of the effective ways to relieve pain during delivery and childbirth. It works within 10-20 minutes of administration. 
  2. It helps during a long labor, allowing to rest and stay alert during delivery, providing a positive experience. It also helps to recover from C-section delivery. 
  3. It can be administered at any time during the delivery process whenever the need arises. 
  4. Helps with longer surgical procedures. 

Cons of Having an Epidural

  1. Epidurals can sometimes cause a sudden drop in BP, arising from the need for oxygen and medications. 
  2. Few women may experience side effects like fever, rashes, shivering, dizziness, nausea, and back pain. Severe headache also occurs if there is a leakage of spinal fluid. In rare cases, permanent nerve damage can also occur due to bleeding or infection in the epidural area. 
  3. The use of epidural reduces the ability to push during delivery. 
  4. It increases the risk of perineal tear. 
  5. Numbs the lower body after childbirth. 
  6. May cause difficulty in urination and need the use of a urinary catheter. 7. May cause respiratory distress in babies after birth. 

Options Other Than an Epidural to Manage Pain

  1. Opioids: It is given by injection or via IV. They don’t provide as much relief as compared to an epidural. Forceps or vacuum is likely to be required to help with the birth in case of epidural, unlike opioids. Opioids can result in certain adverse effects, such as slowing the heart rate and breathing of the baby. A medication to reverse the effects of opioids was given to babies whose mothers received opioids. 
  1. Nitrous Oxide: It is known as laughing gas, is an inhaled analgesic that shows its effect within a minute. It doesn’t drop the pain and requires inhaling before every contraction. It has side effects like nausea, vomiting, dizziness, and drowsiness. 
  1. Pudendal block: It is inserted into the vagina and in the pudendal nerve before the baby’s head comes out. It is a numbing medicine that provides some relief and lets you remain awake and push. There are no adverse effects of this medicine. 
  1. Natural remedies: Natural remedies are either used alone or in combination with medicine. An application of heat or ice to the lower back, massage, taking warm showers, using a labor ball, and settling into a comfortable position are some of the remedies. 

Conclusion

It is a responsibility to deliver the best analgesia possible during labor. This is accomplished with epidural analgesia. Epidurals do not increase the number of cesarean sections or the occurrence of back discomfort. Yet, it is necessary to minimize any effect on labor time and operative vaginal childbirth rates by decreasing motor block using low-dose local anesthetic and opioid combinations. 

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