Obstetrics
During 2010, over 5770 deliveries utilized anesthesia in the Women’s Building at Christiana Care Health System. Of the 31 physicians in ASPA, a large majority are regularly scheduled to provide Obstetric analgesia or anesthesia. ASPA provides a dedicated anesthesia service (anesthesiologist and nurse anesthetist) to the Women’s Building 24 hours/day, 7 days/week, 365 days/year.
What is epidural analgesia?
Epidural analgesia refers to the placement of an epidural catheter during labor to relieve the pain of childbirth. The epidural catheter is a long tube, smaller than a typical labor intravenous, taped to your back and connected to an infusion of dilute local anesthesia and pain medication.
Who places my epidural and when?
Your epidural catheter is usually placed by an anesthesiologist. The timing of your epidural placement depends on the orders written by your OB physician. Often, your epidural is placed once you begin active labor. From the time your nurse contacts the anesthesiologist, it is uncommon to wait more than 20 minutes to have you epidural placed.
What if I have a Caesarean Section?
If you are scheduled for an elective Caesarean section, your anesthesia team will discuss your options with you. In obstetric anesthesia, we try to provide spinal (less often, epidural) anesthesia for scheduled C-sections. If you have an epidural for labor and require a C-section for delivery of your baby, the epidural can be injected with medicine to provide anesthesia for the surgery.
We elect to provide spinal or epidural anesthesia for surgical deliveries because the risks of anesthesia to the mother and baby are greatly reduced when compared to general anesthesia.
Does my epidural wear off?
When you have an epidural placed, you are connected to an infusion pump that delivers a continuous flow of medicine to relieve the pain of childbirth. If you begin to experience pain with an epidural in place, your nurse will contact your anesthesiologist to evaluate your pain and, if necessary, to provide additional medication to restore your comfort.
When is my epidural removed?
If you are not scheduled for a tubal ligation soon after delivery, your epidural catheter is usually removed one hour after delivery.
What are the most common side effects of spinal or epidural anesthesia?
The most common side effects are bleeding, infection, headache or reaction to the medication. Uncommon side effects include back pain, weakness or numbness.
Read more about Epidural Catheter for Labor
What if I have a herniated disk or have had back/spine surgery?
A simple herniated disk or laminectomy/diskectomy procedure does not normally exclude you from having a labor epidural or spinal anesthesia. Occasionally, epidural placement in patients who have had extensive back surgery with bony fusions or spinal instrumentation/rods may be more difficult or result in a lesser degree of patient comfort throughout the childbirth process. As a patient, you are encouraged to bring any documentation or X-rays/X-ray reports from any prior spinal surgery to assist your anesthesiologist with epidural placement.
Read more about epidural use during labor for women with corrective spine surgery
