Epidural_Anesthesia__an_Evaluation_of_Risks_and_Benefits

The process of giving birth is a beautiful and wonderful experience. When an expecting mother comes into labor, she has different options to relieve pain. One of those options available is epidural anesthesia. The use of epidural anesthesia may be considered the most effective method of pain relief during labor. However, identifying its overall risks and benefits may be beneficial to alleviate pain when giving birth. Epidural anesthesia blocks pain in a particular part of the body. “It is achieved by injecting pain medication directly into the epidural space of the lower back via a small plastic tube.” (Pillitteri, 1985) This technology becomes extremely useful when a cesarean section must be performed in order to save a baby’s or it’s mother’s life. There are also times where a mother who has had a prolonged labor and is too exhausted for the labor to progress may benefit from using an epidural to help in relaxing and refocusing. Most women are unaware of the side effects of an epidural and therefore use them when they are not needed. The most common side effect is called hypotension which is a drop in blood pressure. This is a problem because it decreases the level of oxygen the baby is receiving and can distress the respiratory system of both mother and baby. Postpartum back pain is another symptom associated with an epidural anesthesia. (Norman, 2003) These side effects are a direct result of an epidural but it is also important to view the facts regarding the effects epidurals have on labor itself. An epidural eliminates the normal mechanisms for the progress of labor. A woman who does not receive an epidural is free to move around during and immediately after childbirth. The labor process is shorter when the baby is delivered naturally compared to when the mother has used an epidural block. (Khafagy, 2010) Although, with an epidural the mother is able to rest if the labor is prolonged. As well as, most of the time an epidural will allow the woman to remain alert and be an active participant during her labor. There is almost always a trade-off when medications like anesthesia are used during labor. Each woman must know and consider the potential benefits and risks and apply them to her own circumstances. The goal of this paper is to find out if the benefits of an epidural anesthesia outweigh the risks. An epidural anesthesia is a neuraxial technique that offers a wider range of applications than a Spinal Anesthetic. An Epidural block can be performed at the Lumbar, Thoracic, Cervical and Caudal level. It can be used during a number of procedures such as operative anesthesia, obstetric anesthesia & analgesia, post-op pain control and chronic pain management. It can be used as a “Single Shot” or with a catheter that allows intermittent boluses or a continuous infusion. One advantage of an epidural is that the muscle blockade can range from none to complete. Everything can be regulated and changed by: choice of drug, dosage, level of injection. Epidural techniques have the advantage of better control of level (and also of sympathetic blockade). Epidural techniques allow for the placement of a continuous catheter which is especially useful for: 1) Cases of unpredictable duration 2) Prolonged postoperative analgesia 3) Chronic pain control 4) Obstetric Analgesia & Anesthesia To be able to choose the most appropriate anesthetic dose, concentration and volume of LA, the anesthetist must be familiar with the variables that affect spread and duration of Epidural Anesthesia. The variables are more numerous than those of spinal anesthesia and Baricity plays a VERY small factor when dealing with Epidurals, whereas in a Spinal, baricity is a KEY factor in spread and distribution of the block.