Anesthesia during childbirth: types, consequences for mom and child, reviews. Is it worth doing anesthesia during childbirth, is it dangerous: minuses, for and against

The article describes possible types of pain relief, their advantages and disadvantages, as well as probable complications after anesthesia in the mother and child.

Anesthesia in childbirth is an important process. It happens that the course and even the outcome of the birth depends on the type of anesthesia.

“Turning off” or reduction of pain helps to alleviate the state of the woman in labor during natural delivery, as well as conduct a cesarean section, both under general and regional anesthesia. However, at the same time, the use of anesthesia can negatively affect the health of the mother and child.

What anesthesia is done during natural birth and cesarean section: species

For pain relief of natural birth, it can be used:

• a drug analgesic - introduce intravenously or intramuscularly to reduce pain sensitivity during contractions and attempts
• intravenous anesthesia - an anesthetic is introduced into the vein to ensure a short -term sleep of the woman in labor at the time of the most painful procedures (for example, the separation of the placenta parts)
• epidural or spinal anesthesia - anesthetizes the period of contractions and disclosure of the neck, is carried out by introducing an anesthetic into an epidural (spinal) area
• local anesthesia - It is used for painless suturing of ruptures and cuts, entered directly to the site, which needs to be anesthetized

With cesarean section, the use of anesthesia is possible:

• general - a complete shutdown of the patient’s consciousness, which is ensured by introducing anesthetics through a venous catheter or respiratory apparatus
• spinal - short -term shutdown of nerves pain in the spine
• epidural - blockade of transmission of pain on nerves in the area of \u200b\u200bthe spine, leading to loss of sensitivity in the lower body, is ensured by introducing an anesthetic into a certain area using a special epidural needle

Spinal anesthesia in the spine during childbirth: what is it called?

Spinal anesthesia is often mistakenly called epidural. However, it is important to understand that, despite the similar action and the same place of the puncture, these are two completely different types of anesthesia that have a number of fundamental differences:

1. Spinal anesthesia is introduced into the spinal space, the epidural - into the epidural.
2. Spinal anesthesia blocks the area of \u200b\u200bthe spinal cord, the epidural - the final sections of the nerves.
3. For the introduction of spinal anesthesia, the thinnest needle is used, for epidural - the thickest.
4. The place of puncture for spinal anesthesia is the lower back, for the epidural - any vertebral department.
5. Epidural anesthesia is spent 10 - 30 minutes, spinal - 5 - 10 minutes.
6. Spinal anesthesia will act after 10 minutes, the epidural - after 25 - 30 minutes.
7. If spinal anesthesia did not work, the woman in labor is made general anesthesia, if the epidural, increase the dose of analgesic.
8. The severity of side effects (dizziness, nausea, pressure surge) after spinal anesthesia is brighter than after epidural.

Thus, each of these types of anesthesia has its own advantages and disadvantages, but there is no need to say that one of them is safer. The most important thing is that anesthesia is performed by an experienced anesthetist who can competently prepare the patient for the upcoming childbirth.

Epidural anesthesia - indications: in what cases do they do?

Indications for epidural anesthesia:

• operational delivery (multiple pregnancy, incorrect position of the child, large fetus, multiple entanglement of umbilical cord) is necessary)
• a premature child (anesthesia allows you to relax the muscles of the mother’s pelvis, which reduces the resistance and pressure on the child during childbirth)
• increased pressure in the woman in labor
• weak or incorrect birth activity, slow disclosure of the neck
• fruit hypoxia
• painful, exhausting woman fights

Important: in some clinics, the use of epidural anesthesia without indications is practiced. So that in childbirth a woman feels comfortable and confident, pain relief is made at her request.

How and where do epidural anesthesia do in childbirth?

Epidural anesthesia is performed as follows:

1. The pregnant woman sits down, bending his back, or lies, holding his legs to his chest.
2. The anesthetist determines the position of the woman’s body and asks her to remain completely motionless.
3. Make a preliminary anesthetic injection to relieve sensitivity at the site of the puncture.
4. Anesthesiologist produces a puncture and introduces the needle.
5. A catheter is introduced along the needle, at this time a woman can feel the so -called “background” in her legs and back.
6. The needle is removed, and the catheter is fixed with a layer. He will stay in the back for a long time.
7. A test is carried out by introducing a small amount of the drug.
8. The main part of the painkiller is administered either in small portions continuously or once the entire dose with a repeat no earlier than 2 hours after the first portion.
9. The catheter is removed after the end of the birth.

Important: during a puncture, a woman needs to remain motionless. Both the quality of anesthesia and the probability of complications after it depend on this.

The catheter tube is introduced into the narrow epidural space, which is located near the spinal canal. The supply of an anesthetic solution blocks pain, since the nerves responsible for its transmission are temporarily “disconnected”.

Video: How is epidural anesthesia done during childbirth?

Important: if during the introduction of the drug a woman feels any unusual changes in her condition (dry mouth, numbness, nausea, dizziness), she must immediately inform the doctor. You should also warn of a fight if it begins during a puncture or the introduction of an anesthetic.

Complications after epidural anesthesia during childbirth

Like any drug intervention, epidural anesthesia can cause complications, including:

• A decrease in pressure, which is accompanied by nausea, vomiting and weakness.
• Severe pain at the site of the puncture, as well as headaches, which is sometimes possible to cure only with the help of medicines. The reason for this phenomenon is the “leakage” of a small amount of cerebrospinal fluid to the epidural area at the time of the puncture.
• Difficulty breathing due to blocking nerves in the area of \u200b\u200bintercostal muscles.
• A accidental hit of anesthesia into Vienna. It is accompanied by nausea, weakness, numbness of the muscles of the tongue, the appearance of an unfamiliar taste.
• Lack of anesthesia effect (in each 20 case).
• Anesthetic allergy that can provoke anaphylactic shock.
• Feet paralysis is very rare, but still the cause of epidural anesthesia.

Anesthesia during childbirth: for and against, minuses

Each woman should independently decide whether she needs anesthesia in childbirth if there are no direct indications for this. Undoubted Pluses of childbirth with anesthesia it could be considered:

• the maximum pain relief of childbirth
• the opportunity to relax in childbirth, not tormented by pain in contractions
• prevention of increasing pressure
• “Cons” of childbirth with anesthesia:
• loss of the psychoemotional connection of the mother and child
• the risk of complications
• loss of strength due to a strong decrease in pressure

The consequences of epidural anesthesia after childbirth for mom

The likely negative consequences of the "epidural" for the woman in labor:

• spinal cord injury arising from high pressure of the introduced analgesic
• damage to the vessels of the epidural space, leading to the occurrence of hematomas
• the introduction of infection during the puncture and the further development of bacterial complications (septic meningitis)
• itching of the neck, face, chest, trembling hands
• increasing body temperature after childbirth to 38 - 38.5 ° C
• urine delay, difficulties with urination for some time after childbirth

Epidural anesthesia during childbirth: consequences for the child

Epidural anesthesia can also have a negative effect on the child. In babies who were born using anesthesia, they can be observed:

• fall of heart rate
• respiratory disorders, often requiring mechanical ventilation
• difficulty sucking
• violation of motor skills
• encephalopathy (5 times more often than in children born without anesthesia)
• violation of communication with the mother

Is it worth doing epidural anesthesia during childbirth?

There is no clear answer to the question of the need to use epidural anesthesia during childbirth. In each individual case, the future mother should discuss with the doctor the possible consequences in case of refusal (or consent) of anesthesia and decide.

Epidural anesthesia it is necessary to do if there are direct medical indications or a woman in labor to this cannot endure pain.

A self -confident woman who has no direct contraindications for natural delivery without the use of anesthesia will be able to do without anesthesia.

The headache in the back can be after epidural anesthesia during childbirth?

Strong headache and back pain are frequent consequences of epidural anesthesia. These unpleasant sensations can occur for a long time after childbirth. They appear as a result of a random puncture of the cerebral membrane at the time of introduction of the needle.

Important: random damage to the brain shell occurs in 3 cases out of 100. In the future, more than half of the injured women have many months of headache and back pain.

To stop these pains, in most cases, a second medical intervention is necessary.

Do they do epidural anesthesia with free, second births, are they doing to everyone?

Epidural anesthesia during free childbirth is done by agreement with the doctor. The cost of services and medicines spent in the process of delivery using epidural anesthesia may depend on the peculiarities of women in labor.

Anesthesia during childbirth: reviews

Svetlana, 25 years old: I was going to give birth without pain relief. But in the process, something went wrong. I panicked when the fights turned into some convulsions. The neck was opened very slowly, and the pain was unreal. The doctor, looking at my torment, offered me an epidural. I agreed that I had never regretted. The pain after the puncture subsided, I was able to calm down, relax and concentrate. I gave birth easily my son, neither I nor the child had negative consequences.

Olga, 28 years old: She gave birth with epidural anesthesia. 3 weeks after childbirth, pain began to appear in the back. After each “shift”, movements are instantly fettered. It becomes impossible to turn or straighten up. The pain intensifies and repeat 5 to 10 times a day. There is no more strength to endure, but I'm afraid to contact a doctor. It would be better if I gave birth myself, especially since I did not have evidence for the epidural.

Kira, 33 years: After giving birth with epidural anesthesia, 3.5 years have passed, and the legs still hurt. Even at night, sometimes I wake up from severe pain in the legs and back. I can’t walk for a long time because of this, too. Life turned into a nightmare.

Video: Epidural anesthesia