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Last Updated 03/21/2008

 

 

 

 

 

 

Anesthesia for Labor and Delivery

Whether or not this is your first pregnancy, you may wonder about what types of pain relief will be available during your labor and delivery. There is a wide variety of pain relief options available and your obstetrician, nurse and anesthesiologist will work closely together to meet your needs.

 

There are two general categories of pain relief.

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Analgesia
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Analgesia is pain relief without total loss of sensation or consciousness

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Medicines, such as Demerol or Nubain, do not completely stop the pain but do lessen the pain

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Medication is given by IV or muscular injection

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Medicines act on the nervous system and often cause drowsiness

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Anesthesia
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Anesthesia is the loss of sensation

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There are several types of anesthesia

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Epidural Anesthesia
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Epidural anesthesia is the most commonly used form of local anesthesia for childbirth. The epidural numbs the lower half of the body to ease contractions and vaginal and rectal pain as the baby moves down the birth canal and the pain of an episiotomy, if one is needed. It is also used to relieve pain during a cesarean birth.

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Once you and your obstetrician or certified nurse-midwife feel that your labor is progressing, the anesthesiologist will be asked to place the epidural. The epidural is done by injecting medicine into the lower back after numbing the skin in that area. For more information, please read the patient education handout on Epidural Anesthesia For Labor and Delivery

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Spinal Block
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A spinal block, like the epidural, is also an injection of medicine into the lower back, which numbs the lower half of the body. It is most commonly used for cesarean births.  The spinal differs from the epidural in several ways. First, it is injected into the spinal fluid, providing stronger and faster pain relief. Also, the effect of the drug does not last long.

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Pudendal Block
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The pudendal block is an injection given by the obstetrician to block pain in the area between the vagina and rectum (perineum). This form of local anesthesia is especially helpful in pain relief for an episiotomy. An episiotomy is a small incision in the perineum done to widen the vaginal opening for delivery. Tears in the perineum may occur during birth and need to be repaired.

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General Anesthesia
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General anesthetics are medicines that make you lose consciousness. This form of pain relief is used for some cesarean or emergency deliveries. Even though general anesthesia rarely causes serious side effects, be sure to let your doctor know if you or anyone in your family has ever had a reaction or problem with any form of anesthesia.

Recovery

Once the pain medicine has worn off, you may feel discomfort around the vagina, perineum, lower abdomen, or back. If your birth was vaginal, you may be given an over-the-counter pain medicine such as ibuprofen for relief. If you had a cesarean birth, you will be given stronger pain relief medicine.

Common Questions

 

The following is a list of some of the most commonly asked questions and answers about pain medicine for relief during labor and delivery?

Q: When can I have an epidural during the labor process?
A: This is a decision you, your obstetrician or certified nurse-midwife and anesthesiologist must make. However, there are several variables to consider. The first consideration is your labor pattern and the degree of dilation of the cervix. Another factor is whether this is your first, second or third delivery.
Q What should I do if I have special concerns or needs and if there has been difficulty in my family with pain relief procedures?
A: Be sure to discuss these issues with your doctor during one of your prenatal visits. Also, alert the anesthesiologist to any special concerns you may have when you first arrive in labor and delivery.
Q: Which is better, spinal or epidural anesthesia?
A: Each type of anesthesia has its advantages, so an epidural may be better for one situation and a spinal for another. You and your anesthesiologist will make the choice to fit your situation. For most normal labors, the epidural is the most appropriate.
Q: Can I be paralyzed if I have a spinal or epidural?
A: With modern techniques and medications to risk of paralysis is virtually zero. There have been no cases of paralysis ot SMH and none have been reported in the literature for many years
Q: What is a spinal headache?
A:

When a spinal is done, the needle enters a membrane in the spine and is then removed, leaving a little hole which has to seal. This may take a few days. During this time, some patients may develop a headache while up and walking about, but often disappears while lying down. Only a small number of patients get this and it usually lasts no more than a few days. Usually it disappears by itself however, there are medicines and procedures to help.

 

 

Should you have any further questions, please feel free to e-mail us at OBQuestions@SarasotaAnesthesia.com.