Epidural Anaesthesia for Childbirth
An epidural provides very effective pain relief for women in labour. Even though your birth plan may not include epidural pain relief, it is important to know about epidurals before labour as you may not manage with other forms of pain relief and therefore may consider having an epidural once you are in labour.
Epidurals are commonly used in labour for pain relief. Some women elect to use an epidural from the onset of painful contractions, others decide to use them if other methods aren’t effective and some women are advised to use them for obstetric reasons. Epidurals are very helpful in the management of some obstetric problems such as breech presentations, twins and high blood pressure.
How An Epidural Is Administered
Before the epidural is inserted, the Anaesthetist will place a drip in your arm. You will then be positioned, either sitting up or lying on your side, for the insertion of the epidural. After cleansing the skin on your back, the Anaesthetist will numb a small area of the lower back by injecting a little local anaesthetic under the skin. Using a special needle, a thin plastic tube (catheter) is fed between two vertebrae (bones of the spine) and through the ligaments of the spine before the needle is removed and the outer end of the catheter is taped to your back. Made of soft flexible plastic, the catheter will not injure the spinal cord or nerves and is left in place in the epidural space throughout labour . The patient is able to lie in any position that is comfortable for her. The pain relief medication (usually a mixture of local anaesthetic and an opioid) is then injected through the catheter into the epidural space. The pain medicaton can be tailored to provide the best level of pain relief for your particular circumstances, including the option to self administer (PCEA). An epidural allows the Anaesthetist to inject local anesthetic over a longer period of time than is possible with a single spinal injection. Pain relief usually occurs within 10 to 30 minutes.