21 January, 2011

Epidural anesthesia

What is epidural anesthesia?

Epidural anesthesia, which is also known as anesthesia of the nerve roots, is used to numb the nerve roots exit the spinal cord. This is done by local injection of an anesthetic or analgesic (pain medication). It is commonly used during childbirth to ease the pain of it, and has recently been introduced also use surgery to prevent pain that occurs after certain interventions and to reduce complications such as lung infections and thrombosis in the legs lack of mobility.

During childbirth , epidurals usually starts when there are contractions and is given once the cervix has started to dilate. It is quite effective in about 96% of cases, and approximately two thirds of Spanish women benefit from it when they give birth. However, these figures vary considerably from one hospital to another.

How does an epidural?

An epidural blocks the nerves that reach the uterus or other body parts, depending on the level where they are made. These nerve roots are in a space surrounding the spinal cord called the epidural space. It is located within the vertebral column just outside the outer covering of the spinal cord.

How do you put an epidural?

The epidural always puts an anesthesiologist . The epidural space is located by a thin, hollow needle, usually in the bottom of the spine, and after application of a local anesthetic to the skin. Then insert in the space a small plastic tube through the needle and the needle is removed, leaving the tube in place. This tube is usually connected to an automatic pump infusion which is adjusted to supply continuously, until it no longer needed, a certain amount of local anesthetics and analgesics into the epidural space.

What are the side effects?

The most common are:

  • Drop in blood pressure: this happens in most cases and is easily treated by administration of serums and medication at the time. For this reason the patient's blood pressure is often measured as the epidural is administered.

  • Headache : Also known as spinal headache, happens to 1% of patients who received an epidural. Occurs when the needle passes through the dura (membrane that surrounds the spinal cord) and passes into space unintentionally is hosted cord where the cord. This is easily treated by the anesthesiologist.

  • There are special situations in which extra care must be taken with epidural anesthesia, such as when there is a defective placenta.

Can all women have an epidural when in labor?

The use of epidural anesthesia has existed for many years and is a fairly safe and reliable. Yet the practice is not without risk and those patients who can raise their use should receive full details so they can decide for themselves whether or not they want to benefit from this procedure.

some complications may occur, for such as meningitis , have been produced by passage of bacteria from the outside into the vertebral canal, but are rare if you take proper sterilization measures. There is also the risk of paralysis by damaging the nerve roots when administered lumbar epidural because the level at which there is no longer puts marrow and, therefore, the paralysis is caused by the presence of abscess or hematoma.

There are some conditions in which epidural anesthesia is not at all advisable or may be contraindicated, such as certain back problems. Neither should be used when there is increased tendency to infections or bleeding, or when there are certain diseases of the nervous system. If any of these circumstances should always consult the anesthesiologist.

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