Epiduralny anesthesia (it peridural) – an excellent way to clean pain during fights and a rodorazresheniye. As well as the majority of invasive treatments, at this procedure has shortcomings and advantages, but it is rather safe and has considerable advantages in comparison with the general anesthesia as to this type of anesthesia it is applied much more smaller doses of preparations. Epiduralny anesthesia does less harm to cardiovascular system as affects only a lower body, relieving pain. There are indications when such anesthesia does not be applied, namely:
- to patients with violations of coagulability of blood;
- the patient suffering from a koagulopatiya;
- long-term use of aspirin or nonsteroid anti-inflammatory preparations;
- gipovolemichesky shock;
- otsloyka of a placenta;
- infection around introduction of a catheter;
- constant headaches;
- the waist pain (which does not have relations to pregnancy);
- chronic neurologic violations;
- allergy to the drugs used for anesthesia;
- certain heart troubles (if you have a sore heart, surely discuss it with your anesthesiologist);
- inability to cooperate at introduction and installation of a catheter during procedure;
- inability to tell about power of painful feelings or the arisen problems;
- on a place of introduction of a catheter there was a scar from spinal surgery;
- backbone curvature at the patient.
Before to consider possibility of application of such method, readers of Mirsovetov should remember that you can simply not know about existence or absence of some above-mentioned contraindications. It is connected both with lack of full inspection, and with an individual structure of each organism.
It is very important that you understood all risks before deciding that epiduralny anesthesia suits you. Though it is very small, but nevertheless there is a risk of developing of an infection or neurologic trauma. You and your relatives have to discuss all possible problems before signing a consent to carrying out procedure. If you do not understand possible danger or how procedure – epiduralny anesthesia not for you is carried out.
What is the epiduralny anesthesia?
Epiduralny anesthesia – one of anesthesia methods at which medicines are injected by small doses in epiduralny space of a backbone through a catheter. It blocks pain in the nervous terminations of patrimonial ways and , without stopping thus the most patrimonial process. Successfully carried out epiduralny anesthesia guarantees almost painless period of fights and the birth of your child.
Most of obstetricians consider possibility of carrying out epiduralny anesthesia, only if about it the woman in labor asks.
To women in labor with , very dangerous disease, do Cesarean section. Because epiduralny anesthesia bears emotional loading in the majority. But thus pressure in arteries does not decrease. Eklampsiya, as well as a preeklampsiya, are the absolute indication to an operational rodorazresheniye.
This procedure is carried out by the anesthesiologist – the doctor who specializes on means and methods of ensuring anesthesia. Before injecting a drug, your patrimonial process is observed carefully. Near you there will be specially trained expert, up to the birth of the child.
How it occurs?
Epiduralny anesthesia usually is not applied until you enter an active stage of childbirth. You will ask to lay down on the left side, having as much as possible pressed a chin and knees to a breast, or to sit down, having low hung the head and shoulders, and having extended hands forward – in this situation the average line of a back is easier identified. The sitting situation is more preferable as it allows the anesthesiologist easier to look through anatomic reference points. The lower back is processed disinfecting solution to reduce risk of hit of an infection. In a certain place in a lower back anesthetize a skin site of the size of a five-ruble coin by means of a local analgetic. You have to lie as it is possible more quietly while enter a needle of the bigger size into peridural space of a spinal cord. The small thin tube (catheter) is carried out to this needle until reaches the necessary arrangement. Then the needle is deleted carefully. Then enter "a trial dose" of a preparation for check of correctness of placement of a catheter. If the catheter is entered incorrectly, it accelerates the frequency of reductions of heart. If heartbeat in norm, to you enter the first dose of the anesthetizing. The catheter is fixed to your back to add a preparation as required. The established catheter does not limit your movements and is not felt on a back.
The anesthetizing gets to epiduralny space where pass the nervous terminations on which painful impulses get to a spinal cord. The preparation blocks an impulse before it gets to a brain.
3-5 minutes later after introduction of the first dose, nervous impulses which transmit signals of pain to our brain are blocked. The full effect comes in 10 minutes, you should not feel pain in general. After action of the first dose weakens, to you will add the next portion. Usually the drug is injected with frequency at 2 o'clock, but it also depends on the chosen preparation.
After the child is born, a catheter delete. The effect of anesthesia usually completely passes in 1-2 hours. Then you can have a burning sensation in the field of patrimonial ways.
Whether really epiduralny anesthesia is safe?
At present it is considered that epiduralny anesthesia is completely safe for mother and the child. But, of course, the risk is always. Peridural anesthesia can provoke complication (for example, imposing of nippers to the child) that also is risky. The most widespread side effect – sudden lowering of blood pressure at the woman in labor. This problem meets in 1-2% of cases and is dangerous to the woman and the child. If it suddenly occurred, the team of doctors needs to take urgent measures. Most often, the situation manages to be stabilized. Control of the level of a blood pressure is necessary after each introduction of preparations.
Other possible complications:
- the needle is inserted incorrectly and epiduralny anesthesia does not relieve pain;
- loss of control of an urination because of which introduction of a catheter can be demanded;
- back paralysis at introduction of anesthetic to tserebrospinalny space. Respiratory standstill and sharp . It is a serious condition.
Whether epiduralny anesthesia always works?
If the doctor cannot easily define location of peridural space, application of such type of anesthesia is inadmissible. But it happens seldom. Sometimes begins so quickly that to time for anesthesia simply does not remain. In certain cases anesthesia works with places: one part is anesthetized, another – no.
Most of women can carry out Epiduralny anesthesia, but again at an exception of all contraindications (for this purpose it is necessary to pass full inspection). Mirsovetov reminds that all undergone operations on a back, with heart troubles, blood or with an allergy on certain anesthetizing needs to discuss these problems with the attending physician and the anesthesiologist.
Advantages of epiduralny anesthesia:
- simplification of pains during fights, a rodorazresheniye and, if necessary, epiziotomiya;
- reduction of the period of disclosure of a neck of a uterus;
- elimination of pain, and consciousness at the woman in labor remains clear;
- the preparation gets to blood to the child in so insignificant quantity that cannot apply an essential untoward influence on its state.
- mother has to remain in lying situation for the entire period of childbirth;
- mother does not control the body and, perhaps, does not feel process of childbirth. It can affect in touch between mother and the child. The second stage of childbirth can be slowed down because of inability of mother to move and use gravity;
- the woman in labor completely depends on medical staff, and cannot celebrate the physiological requirements itself. Most likely, the woman in labor needs introduction of an uric catheter that bears certain risks;
- the most frequent "bad" consequences for the kid – weak breath (if the dosage, harm minimum is correctly counted).
- seldom, but nevertheless there are very serious problems and which the woman in labor and her relatives have to be warned.
How still it is possible to relieve patrimonial pain?
There are other ways to reduce pain. Many women are helped by the methods studied on courses for young mothers – relaxation, massage, certain poses, visualization, derivation, the breathing exercises done with support of other person. All this is based on your own force and endurance, but quite successfully allows you to control the body.
Epiduralny anesthesia – only one method which can give simplification at pain and discomfort in childbirth. It, really, demands big trust to medical staff. It really rather risky. To make a final decision to you. The understanding of the procedure and its carrying out will help to be defined that is correct and necessary for you.