Anesthesia for Obstetrics:
Today’s expectant mothers are reconsidering the idea that childbirth is “natural” only without medication and some are choosing to have pain relief during labor and delivery to help them experience a more comfortable childbirth. The degree to labor pain depends on many factors including your level of pain tolerance, the size and position of the baby, the strength of uterine contractions and prior birth experiences.
A popular form of management during labor is an epidural block. It decreases sensation in the lower areas of your body while you remain conscious. A local anesthetic will be injected into the lower part of you back between the bony vertebrae. Another injection into the epidural space just outside the spinal canal is necessary to so that a tiny plastic tube called an epidural catheter can be inserted through this needle. Occasionally, this catheter will rub a nerve and cause a brief twitch or tingling sensation down one leg. Once the catheter is in the proper position, the needle will be removed. You can then receive additional anesthetic medications as needed without any other needles. Pain relief will occur ten to twenty minutes after the drug has been injected. You might notice some degree of temporary numbness, heaviness, or weakness in your legs. Throughout your labor your comfort and progress will be checked frequently and your medications adjusted accordingly. Soon after delivery, the epidural catheter will be removed and within a few hours your feeling will return.
Anesthesia for Cesarean births may involve epidural, spinal, or general anesthesia. Choices are dependent upon several factors including your preferences and the medical condition of you and your baby. If you have an epidural catheter in place and a Cesarean birth becomes necessary, the anesthesiologist can inject additional medication through it.
When spinal anesthesia is used for Cesarean delivery, a much smaller dose of anesthetic medication is used and it is injected directly into the spinal fluid sac. Once injected, the onset of numbness is quite rapid. A headache may occur following spinal anesthesia. A persistant headache can be treated with a technique called an epidural blood patch.
General anesthesia for Cesarean delivery is used when a regional block is not possible or is not the best choice for medical or other reasons. It is initiated quickly through and IV and causes a rapid loss of consciousness; thus it is commonly used when an urgent vaginal or Cesarean delivery is required. It is quite safe for the baby.
It is best to remember that you should not eat of drink anything after your labor pains begin regardless of you plans fro delivery or pain control. Sometimes small sips of water or ice chips are permissible during your labor with your physician’s consent.
It is the goal of this Anesthesiology Department to make your labor and delivery as comfortable and as safe as possible for you and your baby. Please discuss any of your anesthetic concerns with your anesthesiologist toward the end of your pregnancy.