Epidural Anaesthesia, its Complications and Side-effects

In recent times, epidural anaesthesia has become one of the most popular methods of relieving labour pain. Hospitals carry on the procedure at large every day given its huge demand by pregnant women. As much as up to 50 percent of expecting mothers are asking their doctors for epidural anaesthesia to alleviate intolerable pain that labour causes. 

If you are expecting your labour or a loved one in your family is, knowing exactly what epidural anaesthesia is could help in making informed choices during the course of labour and delivery which you wouldn’t have to repent later.

What is Epidural Anaesthesia?

Epidural anaesthesia is regional anaesthesia that works to cease pain in a particular area of the body. An injection of an anaesthetic is shot into the epidural space of the spinal cord which causes the sensation to cease in the abdominal and genital and pelvic areas of the pregnant woman.

An epidural anaesthesia aims at providing pain relief rather than causing a total lack of feeling in the injected area. It blocks the nerve impulses from the lower spinal segments which result into decreased sensations in the lower half of the body.

Epidurals are categorised under a class of drugs known as local anaesthetics, which include the likes of bupivacaine, chloroprocaine, or lidocaine. A combination of these medications is made with opioids or narcotics to reduce the required dose of local anaesthetics.

This diluted version of anaesthetics provides pain relief with minimal effects. Combinations of epidurals can also be made with epinephrine, fentanyl, morphine, or clonidine in order to sustain the epidural’s result or to steady the mother’s blood pressure.

Complications of Epidural Anaesthesia

Epidural anaesthesia is generally considered safe and reliable but may sometimes exhibit complications that you might want to look out for. Your doctor will be able to explain the following possible complications of epidural anaesthesia in a better light.

Severe Headaches

Headaches are a common side-effect of surgery but an epidural can occasionally give a more severe headache which is also knows as a post-dural puncture headache. When the lining of your spinal cord (dura) is punctured accidentally during the insertion of epidural, it gives rise to severe headaches.

Infection

Though rare, but infections are a complication of epidural anaesthesia. The site of injection may become infected in the weeks following an epidural. Other serious complications may arise from this such as an abscess forming, which is a painful collection of pus at a given body area.

However, the infection may seldom spread beyond the injection site to other body parts.

Epidural Haematoma

A rare but possible complication of an epidural is epidural haematoma. It is defined as a collection of blood building up in an organ, tissue or space of your body. A break in the blood vessel wall causes it. 

An epidural haematoma may also lead to severe nerve damage, such as complete loss of movement of the lower half of the body, including your legs. This further complexity is very rare but is possible.

Other rare yet possible complications of an epidural anaesthesia includes fits, breathing difficulties, nerve damage leading to a numb patch of skin and even death.

However, very serious complications after an epidural are as rare as between 1 in 80, 000 and 1 in 320, 000.

Side Effects of Epidural Anaesthesia

Epidurals can certainly pose some temporary side-effects that need to be monitored by the doctor after giving the injection to an expecting mother. The following side-effects of epidural anaesthesia should be anticipated and alleviated:

• The woman’s blood pressure going under epidural anaesthesia may suddenly drop and should be checked timely to ensure adequate blood flow to the baby. Doctors may give IV fluids, medicines, and oxygen to treat the sudden BP drop in the woman
• Lying in one position after an epidural anaesthesia can cause a stopped or slowed labour in the pregnant woman. This is why, you will need to keep changing sides while you lay in the bed and the doctors will have to regularly check foetal heart rate
• Shivering, ringing of the ears, backache, soreness at the insertion site, nausea, and difficulty in urinating are some milder side-effects of epidural anaesthesia experienced by pregnant women opting for it
• The first few hours after the epidural anaesthesia can be marked by a feeling of numbness in the lower body and the patient may need aided walking
• Open to two or more interpretations of some researches show that sometimes the baby born after epidural anaesthesia might find it difficult to “latching on” to the breast while feeding
• If you are pondering over the idea of getting an epidural done, make sure to discuss the procedure with an anaesthetist. They will be able to provide further information and advice about the risks of developing complications such as those described above

Image Courtesy: Getty

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