In recent years, it has been widely used different methods of pain relief medication delivery Anesthesia delivery - possible methods . Among them is widely spread epidural. This anesthesia is used not only in the course of independent (of course) birth, but also for the production of caesarean section.

What is epidural anesthesia

Epidural (epidural) anesthesia - regional anesthesia is the method, the essence of which is the introduction of drugs into the epidural space. In carrying out this anesthesia is possible to achieve three effects:

• analgesia - the loss of pain sensitivity;
• anesthesia - the loss of overall sensitivity;
• muscle relaxation - relaxation of muscles.

Drug administration into the epidural space is produced, enveloping the solid shell, and stored throughout the spinal cord. The name of this type of regional anesthesia is due to the translation from the Latin terms (peri - «around», epi - «on», dura mater - «dura").

The mechanism of action is based on an epidural penetration of drugs through the hard shell of the spinal cord, their influence on the nerve roots and the closure of the latter, which leads to a weakening of pain (e.g., inflammation of the nerve roots or intervertebral disc), or loss of sensation.

Preparations for epidural anesthesia

Mainly for epidural anesthesia used topical anesthetics: procaine, lidocaine, bulivakain, ropivakian. For enhancing the effect of the introduction of the solution may be opiates - narcotic analgesics such as promedol, morphine, and others. However, in Russia their use for epidural anesthesia is forbidden. Occasionally a solution is added clonidine and ketamine (a general anesthetic for preparation). Local anesthetic solution is prepared at a dilution of adrenaline (1: 200,000), which enhances the effect of the anesthetic.

In some cases, carried out an epidural?

Epidural anesthesia is commonly used during childbirth, especially if recent events (discoordination labor clinically narrow pelvis of the first degree, dystocia cervix), as well as for pain relief during labor in obstetric patients who have not been psychoprophylactic prevention and unprepared for childbirth (pain is often due to fear). Other areas of epidural anesthesia:

• local anesthetic in inflammation of the spinal cord and intervertebral discs;
• addition to general anesthesia for laparotomy (abdominal dissection);
• the production of caesarean section Caesarean section: do not rush to go under the knife   (the best option - no influence of drugs on the fetus, mothers consciousness is preserved, there is the possibility to make newborn baby to the breast immediately after extraction);
• postoperative pain (in this case in the epidural space left catheter through which administered anesthetics);
• analgesia for certain types of spinal pain.

Advantages and disadvantages

Epidural anesthesia, as well as all methods of anesthesia has its advantages and disadvantages.

Advantages of an epidural:

• full preservation of consciousness of mothers during birth or caesarean section (woman hears the cry of the child may pick him up and attach to the chest);
• there is no risk of injury to the trachea and aspiration syndrome as during endotracheal anesthesia;
• the possibility to extend anesthesia for any period;
• the relative stability of hemodynamic parameters (blood pressure, pulse);
• there is no negative impact on the fetus anesthetic (they do not cross the placental barrier).

The disadvantages of epidural anesthesia are:

• broken bond between mother and child (the child also needs pain relief during labor, and gets it by producing hormones of happiness - endorphins the body mothers, epidurals during these hormones are not synthesized);
• headache after anesthesia (due to leaking spinal fluid into the epidural space in case of accidental damage to the hard shell);
• subarachnoid hemorrhage;
• accidental introduction of high-dose anesthetic;
• allergic reaction to the anesthetic drug medication;
• technical difficulties;
• long exposure period and anesthetic suppression sensitivity (approximately 20 minutes after manipulation);
• inadequate analgesia (low dose of the anesthetic or absence of its effect on the roots of the spinal cord).

Anna Sozinova

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