The advantages and disadvantages of epidural anesthesia?


We have all heard of epidural anesthesia; Most people consider it as the safest form of anesthesia and that it produces fewer side effects. Its defenders argue that it does not interfere at all in the conscience and the lucidity of the mother, relieving the pain completely; his detractors warn about the risks of medically manipulated delivery.

But what should we know before deciding to apply the epidural? Here we tell you the advantages and disadvantages of this form of anesthesia.

What is epidural anesthesia?

The anesthesia is the loss of sensation in an area of the body; this includes both thermal and tactile sensations as well as painful ones. We can manage to anesthetize a part of the body thanks to drugs that block nerve transmission at different points.

One of the most popular types of anesthesia is epidural anesthesia, discovered by the doctor from Huesca Fidel Pagés in 1921. In this anesthesia, the drug is introduced into the space around the dura mater (a fibrous membrane that surrounds the entire central nervous system). ).

The drug is usually a local anesthetic that is capable of blocking nerve transmission in the bone marrow where it is applied so that the sensitivity is lost from that point downwards. That is, if epidural anesthesia is applied to the neck, sensitivity will be lost throughout the trunk, legs, and arms; if the epidural anesthesia is applied in the lumbar region the sensibility of waist down will be lost, and this form of anesthesia is the one that is used during the childbirth.

Each pregnant woman must decide for herself, after informing herself and letting herself be advised by the professionals indicated, if she wants to be administered this type of anesthesia during childbirth, or not. Like almost everything, the epidural has advantages and disadvantages and, although the risks that present at present are minimal, it is convenient to know them before making a decision.

Using epidural anesthesia has several advantages for the mother and the baby:

Advantages of epidural anesthesia

  • Less psychological wear for the mother: the pains of childbirth, although bearable, can be very intense, and each pregnant woman perceives them with greater or lesser intensity according to her pain threshold. The usual thing is for the mother to finish the labor physically and psychologically exhausted, the epidural can alleviate this and allows the mother to enjoy the moment of delivery more easily.
  • Intrapartum control: the characteristics of this type of anesthesia allow to increase or decrease the concentration according to the effects needed by doctors and pregnant women.
  • Valid for cesarean: in many occasions during childbirth there are complications, and what was thought to be a safe vaginal birth can become a complication ,which must be solved quickly by cesarean section. Epidural anesthesia allows performing the cesarean by simply increasing the concentration of a drug, without the need to resort to other anesthetic techniques.
  • Minimal invasion: unlike other anesthetic techniques, the epidural does not require the puncture of large nerve groups or other compromised anatomical regions. This means that the risk of irreversible physical damage is minimal.
  • Minimum effect on the baby: any drug that is administered to the mother cannot reach the baby and have an effect on him. In the case of epidural anesthesia, it is very difficult for this to occur, since the medication has a local effect on the spinal cord, and the amount that passes into the mother’s bloodstream is minimal.
  • Vigil mother: perhaps one of the most positive aspects of epidural anesthesia is that it manages to control the pain of childbirth without the mother losing consciousness at any time and can be awake and lucid at that time so unique that is the birth of a child.
  • Reduces muscle activity in the legs, benefiting diabetic women who, in this way, can better balance their insulin and glucose needs.
  • It reduces the work done by the lungs during labor, so it can be beneficial if you have a lung or heart disease.
  • Its effect lasts about 2 hours and it is possible to reinforce if necessary or make the effect disappear as the birth approaches so that you can completely control this last moment, although the contractions can cause you an unpleasant sensation if you have not experienced anything until then.


Disadvantages of epidural anesthesia

Not all are advantages, epidural anesthesia also has some disadvantages

  • Difficulty to push: Although the epidural anesthesia can be regulated so that it only affects the pain sensitivity, it is common to also lose deep sensitivity and that the woman does not perceive the contractions. This prevents you from feeling the need to push, and the delivery may be longer than usual.
  • Fall of the blood pressure: by blocking the spinal cord in the sections that influence the sensitivity can also be affected sections that control the autonomic nervous system of the body, the part of the nervous system that controls the unconscious vital functions, such as body temperature, digestion or blood pressure. If it is affected, the blood pressure figures may fall below acceptable levels.
  • Headache: especially after childbirth it is possible for the mother to suffer a heavy headache, which increases when it is incorporated and decreases when lying down resting. This is normal when manipulating the nervous system, although it must disappear within a few hours, and there must be no other signs that indicate greater severity; if so, the doctor will rule out that the dura mater has been punctured, a situation that should not entail any risk.
  • Meningitis: today causing an infection of the central nervous system when performing an epidural puncture is something extraordinary, since the levels of sterility and cleanliness are very strict. It is a complication of the past.
  • Difficulty urinating: As we have explained when referring to the drop in blood pressure, it is possible that blocking the autonomic nervous system prevents the bladder from contracting properly to expel urine. It is a reversible effect over time and, meanwhile, the mother must be probed to be able to evacuate the urine.
  • Punctual bleeding: as is logical when puncturing the skin can damage small blood vessels that cause local hemorrhages. Less common, but also possible, is that a larger blood vessel is damaged and the hemorrhage causes a hematoma of some importance. Only if it is very large should be evacuated after delivery to avoid infection. Normally the bleeding ceases immediately since the pregnant woman’s organism at that point is highly prepared to coagulate wounds.
  • Higher cesarean rate: it is not clear if epidural anesthesia causes labor to be delivered by cesarean section more often than vaginally. Surely what happens is that the delivery is longer than normal, as explained in the incorrect blockade of deep sensitivity, and as today there are many systems capable of detecting the suffering of the baby more accurately than in the past, causes it to be immediately referred to a cesarean section.

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