Epidural Anesthesia
Genesis HealthCare System is pleased to offer expectant mothers the choice of epidural anesthesia – 24 hours a day, seven days a week.
Epidural is a method of administering pain medication to dull the sensations women feel during childbirth labor and delivery. When combined with breathing and relaxation techniques, epidurals provide increased comfort while enabling women to fully participate in the delivery. Anesthesiologists, medical doctors specializing in anesthesia and certified registered nurse anesthetists (CRNAs), nurses with special training in the administration of anesthesia, work together to provide this popular service.
Preparing you for epidural anesthesia
When you arrive at Genesis for delivery, an anesthetist will do a brief pre-anesthesia assessment. This assessment is completed whether or not you have chosen epidural anesthesia. It helps the anesthesia personnel get to know you and be aware of any health factors that will influence the type of analgesia/anesthesia you may receive if the need arises. The anesthetist will also discuss your anesthesia options and answer any questions you may have.
If you decide you want an epidural, an intravenous (IV) line will be started. Various monitoring equipment will be set up to ensure the safety of you and your baby. You will be asked to sit up or curl up like a ball on your side. Your lower back will be washed with an antiseptic solution and numbed with a local anesthetic. A special needle will be used to locate the epidural space and a very small tubing threaded through this needle into the epidural space. The needle will then be removed and the tubing taped in place.
Frequently Asked Questions
Generally, your obstetrician likes you to be in active labor with your cervix dilated three to five centimeters and contractions every two minutes before epidural medication is given. Once the epidural has been started, you will need to remain in bed until your baby is delivered.
Normally, you will be given only enough medication to ease the pain of contractions. Although your legs will feel a little heavy, you will still be able to move them. You will feel pressure with each contraction and will be able to “push” as instructed by your physician.
The epidural medication will be given continuously by means of a small pump attached to the side of your bed or IV pole. When the pump is turned off, there will be a gradual return of normal sensation during the next hour or so.
The local anesthetics used to produce the epidural differ from most pain medications and do not make your baby sleepy or depress his or her breathing. Healthy babies are born every day to mothers choosing epidural anesthesia.
The same precautions and safety measures are taken with epidural anesthesia as with any services provided at Genesis HealthCare System. Our anesthesiologists and CRNAs are well trained and experienced in providing this service. However, while being a remarkably safe anesthesia technique used on thousands of mothers every day, as with any procedure, there are some well-known potential complications:
Lowered blood pressure
A certain percentage of mothers will experience a drop in blood pressure after the start of the epidural. Increased rate of delivery of the IV solution along with proper positioning usually takes care of this problem. Occasionally, medications are given through the IV to help bring the blood pressure back to normal.
Needle or catheter enters blood vessel
This rare occurrence requires re-insertion of the epidural catheter into a different place.
Accidental dural puncture
The dura is the covering, or sleeve, that surrounds the spinal cord and contains the spinal fluid. If the epidural needle or catheter should puncture this covering and enter the spinal fluid, the catheter will have to be re-inserted in another location.
Approximately one in five mothers gives birth by Cesarean operation. Most mothers are awake during a Cesarean but have been given either an epidural or spinal anesthetic to numb them completely for the surgery. If you have been in labor, have an epidural catheter in place, and should require a Cesarean, additional medication will be given through your epidural to completely numb you for the operation. In a true emergency where either you or your baby is in danger, it will be necessary to use a general anesthetic to put you to sleep.
Additional Information
Any expectant mother interested in anesthesia should discuss it with her obstetrician. Information is also available during childbirth preparation classes at Genesis.