Epidural anesthesia performed to prevent the pain caused by contraction of the uterus during delivery has been used frequently in recent years. Yeditepe University Hospital Anesthesiology Specialist. Dr. Contact Bora directly answers questions of the seven questions.
: What is epidural anesthesia?
Professor Dr. Bora Aykaç: Epidural anesthesia is the event of entering drugs between the membranes surrounding the spinal cord with special needles. The drug administered temporarily stops the neural transmission in the spinal cord. This prevents the patient from feeling pain and provides comfortable operation in the affected area. According to the given drug, this painless period lasts 3-6 hours. If it is to be used for post-operative pain treatment, a very thin, plastic tube (catheter) can be placed in this area so that the duration of the effect can be sustained with repeated drug applications.
It can be used to relieve pain during normal delivery (painless delivery) or can be used in caesarean section. In order to help the mother during labor without pain, lower doses of medication are given to avoid labor pains. Pain is not completely eliminated. If a caesarean section is to be performed, the lower part of the waist is completely numbed and completely painless and numbness is achieved.
: How is it applied?
Professor Dr. Bora Aykaç: Epidural anesthesia is applied in the form of a drug between the membranes surrounding the spinal cord by entering the spine with a special needle from the waist in the sitting or lying position.
After the appropriate position is given to the person to be applied, the place to be entered with the needle is cleaned with the help of germicidal fluids and covered sterile. Once the place of intervention is determined, it is numbed by entering with fine needles and then the epidural distance is entered with special needle. One-time (4-6 hours) anesthesia can be performed by injecting the drug through the needle, or a thin plastic tube (catheter) can be passed through the needle and analgesia can be continued for several days with repeated drug applications.
: How does it work during labor?
Professor Dr. Bora Aykaç: It is performed in order to prevent pain caused by contraction of the uterus during delivery. After the labor pains have been started, the catheter is placed and medication is given to prevent labor pains. Although it is possible to completely eliminate the pain by increasing the amount of medication given here, the pain is not completely relieved, so that the mother can participate in labor and help push the baby out, and the mother is able to withstand and feel uncomfortable.
: Are there risks?
Professor Dr. Bora Aykaç: All kinds of interventions made to the human body, all kinds of drugs given carry certain risks. The most common side effect of this application is the drop in blood pressure. It is treated with the rapid delivery of intravenous serums before and during the intervention and, if necessary, with the help of vasoconstrictors. Another (2-3%) side effect is headache caused by leakage in the cerebrospinal fluid as a result of the level being moved deeper during the procedure. It is possible to treat it in a short time by increasing the water intake and with the help of some drugs. In addition to this, it is very rare that there are risks to drugs such as allergic conditions and inflammatory conditions due to interference and bleeding. However, in careful hands and well observed, these conditions can be identified and treated early.
: Could there be insufficient anesthesia?
Professor Dr. Bora Aykaç: In particular, inadequate anesthesia may develop due to inflammatory diseases and congenital abnormalities around the spine. Sometimes, insufficiency can be seen as a result of the ineffectiveness of the drugs. Although this condition is tried to be corrected with different repetitive drug applications, success is not always 100%.
: Are there any negative risks on mother and baby health?
Professor Dr. Bora Aykaç: The mother may have side effects due to interference. Although these are very rare; low blood pressure, inadequate anesthesia, headache, allergic events related to the drugs used, inflammation at the intervention site, temporary spinal cord, very very rarely some permanent injuries.
There is no known risk for the baby and there is the advantage that the baby does not pass medication over general anesthesia.
: Who does not have epidural anesthesia?
Professor Dr. Bora Aykaç: It is a method that can be applied to any person except for the presence of an inflammatory condition or congenital abnormalities in the area to be operated. It can be applied after very good evaluation and preparation in patients with congenital bleeding disorder. In patients who have undergone surgery in the lumbar region and overweight, the application is relatively difficult but can be performed.