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Epidural

anaesthesia

Painless delivery

The most suitable method of anaesthesia

during labour and delivery is epidural

or peridural anaesthesia or pain relief.

The anaesthetist injects pain-relieving

medication through a small tube in the

back. An anaesthetist is a specialist

doctor having knowledge and experiencein providing all types of pain relief to

patients in the operation room, but he

is also an expert in pain relief during a

delivery.

The epidural

After placing an infusion, you have to lie

on your side or bend forward slightly from

the waist. After disinfecting, you get asmall injection with a local painkiller.

With a special needle the anaesthetist

locates the epidural space. He is very

careful to avoid a perforation of the

membrane surrounding the spinal cord.

Therefore, it is important that you lie or

sit still as long as you are asked to do so.

If the membrane surrounding the spinal

cord is hit by accident, you may have

a headache the next day. This seldom

occurs and we can treat this headache.

When the needle is in the right place, the

anaesthetist puts a fine tube near the

nerves, which conduct the pain of the

contractions. Once the tube is placed,

a tight bandage is applied. After testing

the proper working, a painkilling product

is injected. It may take up to 15 minutes

before you are completely free of pain.

While the effect slowly increases, your

blood pressure is checked regularly. We

check whether the epidural anaesthesia

works well. Insufficient anaesthesia

occurs, but can usually be remedied.

During the progress of labour, we can

repeat the injection through the tube oruse a pump, which continuously admin-

isters small quantities of painkiller. If

this is not sufficient, you can get an ad-

ditional dose of pain medication by push-

ing the button of the pump.

Epidural analgesia is meant to take away

the pain but maintain the feeling of the

contractions. This means that at the end

of labour you still feel when the contrac-

tions get stronger, so that you can alsopush for the delivery.

Is an epidural possible for every

delivery?

An epidural is not possible in case

of clotting disturbances, a local skin

infection near the puncture site or an

allergy for painkillers. Back problems

such as scoliosis or disk hernia can makethe placing more difficult but do not rule

it out. After certain back operations, it

may be impossible to apply an epidural.

When do you choose an

epidural?

The anaesthesia ward is at your disposal

24/24. After a call a skilled anaesthetist

can relief the pain within 30 minutes. In

principle, an epidural is possible at any

time. but if your gynaecologist expects

a long labour or a difficult delivery, and

certainly in case of induced labour, he

will advise you to use an epidural in

time, even if the contractions are not too

painful at that moment.

In case of a completely spontaneous

delivery, we also advise you not to

postpone the decision for an epidural

too long. Towards the end of labour, it

becomes more difficult to apply and the

benefit of the painkilling effect is less

long.During the last stage of labour, we can

inject a small quantity of painkiller

directly in the membrane with fluid,

which surrounds the spinal cord. This is

done with a very thin needle, so that the

risk of having a headache is very small.

We do not call it epidural anaesthesia

but spinal anaesthetic. This technique

is also often used in case of a caesarean

section. If you are at the point of giving

birth, epidural anaesthesia is no longerapplied because it would not be effective

in time.

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What are the side effects of

epidural anaesthesia?

A drop in blood pressure: this can be

compensated by an infusion or with

medication.

Numb feeling in the legs and heavy

legs, you may not leave the bed

during the anaesthesia.

Backache: a few days pressure pain

near the puncture site. Long lasting

backache is not caused by the

epidural, but can be a result of the

pregnancy.

Very small risk of a headache (see

above), which can be treated

successfully.

What are the advantages of an

epidural?

It reduces the stress of labour and

gives you the comfort of pain relief,

which is beneficial for both you and

your baby.

It allows you to rest between labour

and be better prepared for the

delivery.

There is no risk for the baby.

Have you had an epidural before? If

so, with good result?

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Did you attend the informationevening for pregnant women?

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Do you have a deviation of the spinal

column?

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Do you take certain medicines? Which

ones? Did you take any aspirin containing

medication last week?

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Are you allergic to certain

medicines?

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Permission for epidural

anaesthesia

The patient

I confirm that I was informed about the

advantages and possible side effects and

complications of epidural anaesthesia.

I give the doctors of the anaesthesia

team permission to apply an epidural

anaesthesia.

Name:...............................................

Further information can be obtained at

the prenatal information session, each

third Monday of the month.

Appointments to consult an anaesthetist

about epidural anaesthesia can be made

through the anaesthesia administration

office: telephone 03 443 36 13.

More information at

www.anesthesie-augustinus.be.