HealthPartners - Preparing for childbirth

Possible side effects • Inadvertent spinal block – If the membrane holding your spinal fluid is punctured by a needle or catheter, you may absorb a higher-than-optimal level of anesthetic. This can cause you to have a post-spinal headache after delivery that may require treatment. • Ineffective pain relief – Approximately 85% of people experience total pain relief from an epidural block. Others experience only partial relief, and some get no relief at all. • Effect on labor – Epidural anesthesia can slow labor, especially if you receive it too soon. An epidural can also interfere with pushing, making it harder for the baby’s head to crown. At other times, it may actually speed up labor. • Blood pressure – One of the most common effects of an epidural block is a slight drop in blood pressure. Your blood pressure will be carefully checked and you will receive a steady stream of fluids through your IV to minimize this risk.

EPIDURAL BLOCK Epidural anesthesia is the most common form of regional anesthesia used during labor. Regional

POINTS OF INSERTION FOR SPINAL AND EPIDURAL ANESTHESIA

SCAN + PLAY anesthesia blocks sensations of pain across a large area of the body while you remain conscious. An epidural block offers pain relief to your lower abdomen during contractions and may even decrease sensation to the legs and birth canal. You will receive the anesthetic medication through a small, flexible tube called a catheter placed in your lower back. Because no one knows how long you will be in labor, the epidural catheter can stay in place and deliver a continuous flow of pain-relieving medication until your baby is born. Before you can receive an epidural, you’ll need to have an IV in place and have normal results from your lab tests. Once the epidural tube is in place, you’ll receive continuous fetal monitoring, frequent blood pressure checks, and possibly a urinary catheter . You will also have to stay in bed because of numbness in your legs. Not everyone can have an epidural block. Tell your health care provider if you know or suspect you may have any of the following conditions: • Bleeding or coagulation problems • Infection near the site of needle or catheter placement • Certain neurological disorders • Some types of earlier lower back surgery

EPIDURAL SPACE

SPINAL SPACE

SPINAL BLOCK A spinal block is sometimes called a “spinal.” How you receive spinal anesthesia is similar to how you receive epidural anesthesia. The main difference is that with a spinal, the anesthetic medication is injected directly into the space around your spine instead of into a catheter. A spinal block can help relieve pain in your lower abdomen, legs, and birth canal for as long as 2 hours. This makes it a good choice for a scheduled cesarean birth or an unplanned cesarean birth if you haven’t already had an epidural block.

• Any significant spinal irregularities • A recent tattoo at the injection site

66 Your Guide to Labor and Birth