Anaesthetic procedure for emergency epidural in labour

Anaesthetic procedure for emergency epidural in labour


I just remember the pain ramping up quite significantly so I suppose I was just very keen for someone to help me and knew that an epidural would be a good way of taking the pain away I felt like it was the right time to go for that option an epidural is a really fine plastic tube that’s put into the bottom of the back and the aim of an epidural is to reduce the pain of the contractions of labour when the anaesthetist came into the room once I’d asked for an epidural she made sure that she spoke to me about the risks and I remember saying to her it’s fine it’s fine just please can I have the epidural because I was in a lot of pain at that point and she made a point of saying we do need to talk about the risks and explained what those were to me and I felt that she explained them well there’s a risk of about one in a hundred of a particularly severe type of headache which usually happens in the first couple of days after an epidural or a spinal anaesthetic there’s a really small risk of damage to the nerves themselves which is very rare if it was happen it’s most likely to be a patch of numbness in the leg that goes away on its own over a few weeks to months and that happens to about 1 in 10 to 15,000 women the risk of it being a more permanent weakness or numbness of the legs is incredibly small in the region of about 1 in 100,000 the epidural is very safe all the medications that we use stay in the back of the mother and therefore don’t reach the baby if the blood pressure drops with an epidural that may well affect the baby and that’s why we have to deal with that quickly if that happens I felt very well-informed about what was going to be involved in having the epidural because I’d had a chat about it with my midwife before the labour had really kicked in I did feel like I understood what would be involved You will need to have a drip put into one of the veins usually in your hand or your arm and the reason for this is that having an epidural can make your blood pressure drop and having the drip in allows us to deal with that very quickly the midwives will attach you to a monitor called a CTG which monitors the baby’s heart rate and that will need to be on before you have the epidural during you having the epidural and then afterwards for a period of time just to make sure that the baby is happy we would normally get you to sit on the edge of the bed in your own delivery room and we need you to try and bend forward curl over around your bump so that you open up the spaces to the bones in your back you can carry on using the gas and air if you’re using that already that’s fine and you must try and keep as still as you can and let us know when the contractions are coming and going because we can pause what we’re doing while you’re having a contraction but you still need to try and keep as still as you can I had to curl my back over and sort of round to let the anaesthetist get the right position to put the epidural in for me and that was quite a hard thing to do during a contraction but what I really remember is curling over a cushion a pillow to keep me more comfortable and my midwife was squatting down and and talking me through exactly what was happening and telling me that I needed to stay still and that I was doing well and reassuring me about what was happening which I found really helpful we then put some local anaesthetic into the skin of the back which does sting a little bit as it goes in and it then shouldn’t be painful to have the epidural put in you should feel a pressure or an aching type feeling sometimes some clicking sensations when the epidural is put in if you feel any sharp pain then you must tell the anaesthetist at the time sometimes people get a little bit of an electric shock feeling just as the little tube is being put in but the anaesthetist will warn you when this might happen sometimes your blood pressure will drop and that’s usually within the first half an hour of having an epidural so we will be keeping an eye on your blood pressure during this time I do remember the local anaesthetic being put into the bottom of my back first because that’s the bit that is a bit uncomfortable it’s a bit like if you’re at the dentist or you have the bit of stinging like you know a small bee sting type feeling but the local anaesthetic works so quickly to numb that pain that it’s only kind of minor discomfort compared the labour it’s not it’s not anything to be very worried about while the epidural is being put in I think I just felt like a pressure type sensation I didn’t feel any pain after that initial local anaesthetic being given just a pressure type feeling in my lower back so once the epidurals in and the anesthetist will put two doses of local anaesthetic into the epidural to get it working in the first place about one in twenty epidurals we can’t get them to work well enough and we have to put a second epidural in to get you comfortable they’ll then attach it to a drip which is attached to a pump and that will continually give some medicine down the epidural during your labour to keep the numbness going everybody is slightly different and needs a different amount of local anaesthetic so there’s also a button attached to the pump that you can press if you start to feel slightly more again after the epidural started working you can press it and it gives you a bolus dose from the Machine the anesthetist spent some time making sure that the epidural was working well and it felt initially like my legs felt very warm and I’ve initially felt a big relief in the amount of pain but mainly like pressure that I was feeling before went away you have a clicker where you can administer the drugs yourself so if you feel like it’s not working very well you can give yourself a known top-up or a bolus which is very safe to do because it’s done in a very controlled way I purposely didn’t want to top-up because I wanted to be able to feel the pressure of the contractions so that I knew when to push if you are not fully aware of when your contractions are or how you’re pushing is because you’re quite numb it’s difficult to know what your pushing is it makes it more difficult to push well it does also increase the risk of you having to have help getting the baby out and that’s in terms of a forceps or a suction cup it’s very common to have a slightly sore bruised back for a few days after an epidural as you’d imagine with an injection anywhere anywhere it feels a bit sore and it’s not associated with any long term back pain I think it’s important to keep all options open in labour all that pain relief options open because you never quite know how your labour is going to go but the epidural definitely made it easier for me to cope with epidurals are something that many women need during their labour it’s not something that you should worry about they’re very safe we do lots of them here and if you have any questions you should ask to speak to an anesthetist when you arrive on delivery suite

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