Regional anesthesia: Spinal and epidural blocks
Epidural anesthesia is a popular choice for pain control because it does not affect your ability to push during labor.
With this procedure, medications are injected near the nerves of the low back to block pain signals from your lower body, even though you remain awake and labor is usually not significantly slowed. An anesthesiologist typically administers this type of anesthesia.
With an epidural block, the medicine is injected into the sac that surrounds the spinal cord. Before the medications are injected, a numbing medication is given into the lower back.
An epidural block can be used for a Cesarean delivery.
With a spinal block, both contractions and the ability to push are temporarily abolished. With a spinal block, the anesthetic is injected into the subarachnoid space surrounding the spinal cord. A spinal block is usually used when a Cesarean section or an instrumented delivery (e.g.
Pain Relief During Labor
forceps or vacuum extraction) is planned. A spinal usually provides better pain relief than an epidural and may take several hours to wear off, at which time sensory and motor function of the tissues/muscles controlled by the previously blocked nerves will return.
Because many women are not able to urinate immediately following regional anesthesia, a catheter may need to be inserted into the bladder until the spinal or epidural block wears off.
A relatively uncommon complication is a headache which begins after the anesthesia wears off.
Both types of anesthesia may temporarily reduce blood pressure, although this is more commonly seen with a spinal block.
A spinal block requires less medication and is typically given only one time, while, with an epidural block, a catheter may be inserted into the epidural space for repeated delivery of anesthetic medications as necessary.
An epidural block takes about 10 to 20 minutes to work, and because a catheter is inserted into the epidural space, the effects can last as long as needed due to the ability to inject more medication.
A spinal block begins working immediately, but its effects last only about 2 ½ hours.
It is possible to have a combination of both spinal and epidural anesthesia.