Epidural and VBAC - Page 2

[mediumcrunch]

Originally Posted by JayJay

So there is an alternative!

Intrathecals are not universally available. The hospital I am using this time doesn't offer them although they will do the epidural 'light' if you ask. With my last baby (same city) the anesth. did an intrathecal first (so I was comfortable during the epidural placement), then did the epidural. In hindsight I wish he would have stopped at the intrathecal but I didn't know that was an option.

[JayJay]

Darnit really? That is annoying then. I didn't know that. Though to be honest I had no idea about the intrathecal even existing until I knew I needed something to help with the blood pressure and inability to relax my cervix... They told me then. Isn't that funny how intrathecals are not universally available because all it is is morphine in the spine, and one would think anesthesiologists would all know how to do them. So odd because they're so useful!

[DocsNemesis]

I just wanted to add, since I posted on the first page, I've had to switch to an OB and was asking him about this the other day. I really don't want an epidural except maybe if I'm stuck in bed the entire time, which is a possibility, but anyway....when I asked him about it he was like uh, why? And I told him some OB's require or recommend an epidural for VBAC. He said thats idiotic. He said if a cesarean is needed, they would either have the time to do spinal or it'd be such an emergency that, epidural or not, they'd give you general. So he basically confirmed what I was saying-getting an epidural to a point where you could do a cesarean on it would take too long in a real emergency and they'd just knock you out anyway.

Also, I wonder if a normal epidural is in the same location as one for a cesarean? I know I had one in for mine, but it seemed kind of high. That and I got spinal anesthesia too-I'd think a spinal would be required anyway as well? I have no idea...lol

[mediumcrunch]

Originally Posted by DocsNemesis

Also, I wonder if a normal epidural is in the same location as one for a cesarean? I know I had one in for mine, but it seemed kind of high. That and I got spinal anesthesia too-I'd think a spinal would be required anyway as well? I have no idea...lol

IME, it is the same location, it is the amount of meds, sometimes type of meds and rate the pump is set at that changes.

Epidurals can be placed in a fairly wide range of space. I have a minor spinal malformation that can make placing an epi challenging. It took over 90 minutes and 8 tries with my first VBAC. The next day I had a row of bloody holes about 8 inches long on my back. He tried up and down in many different spaces.
Edited to add: with my C-section I already had an epidural in. the ansthesiologist came in and pushed a few more syringes of medication to 'bump it up' to C-section strength, it probably took a good 15-20 minutes (I think, it was almost 17 years ago) of him pushing meds and testing my sensation. It was hours from decision to incision for me though, not minutes.

[DocsNemesis]

Oh, I have the same issue with getting an epidural. They didn't try a bunch of different spots, but the anesthesiologist had to keep pulling the needle back out as he'd hit nerve bundles-can you say OW? Then he'd move it a tiny bit and try again. It took about 40 minutes to get mine in, so not quite as bad, but still a process! He said that I have an extremely small window in between my spinal cord and all of the nerve bundles. Luckily I already knew I had *something* abnormal with my back due to spinal taps and having to go under floroscopy to do them, but I didn't know what the issue actually was.

Anyway, I think thats what my OB was saying-in the case of a true emergency, they wouldn't want to take those 15-20 minutes to get the epidural working right, they'd knock you out and have baby out within a few minutes. I'm sure that's pretty rare though. And luckily I'd probably prefer being knocked out anyway (long story but I completely freaked out with my previous cesarean and really don't want to be awake for another...)