Epidural vs. Spinal (for c-section)

[lexbeach]

It's looking like I may end up with a repeat c-section sometime soon, and am determined to be more educated about my drug choices this time if it comes to that. Last time I had an epidural, and it was a pretty horrible experience. I do not do well with narcotics. The epidural took forever to work (almost 50 minutes, a hospital record), and then stopped working halfway through the surgery (yikes!). So they pumped me full of lots of extra drugs, which kicked in just in time for me to be handed my babies. I was throwing up and out of it all day long, and for me it was the most devastating part of the c-section experience (not being present for my babies on their first day).

I talked to my midwife about it, and she suggested that I get a spinal instead because it does not mess with your head in the same way. Is this true? She then said I could take strong motrin instead of narcotics for post-surgery pain relief. My worry about the spinal is the risk of spinal headache, which just sounds awful. I don't know what the statistics are about it, but I remember that that's why I didn't want a spinal last time.

Any advice?

TIA!

Lex

[rmzbm]

I have had 3 spinals & 1 epidural. (Epi. with #2) ONLY the epidural gave me a headache & it was KILLER...spinals give significantly better numbing & most prefer it's use. I have NEVER required pain meds. after either. Nothing, not even tylenol... Oh, the epidural also made me sick to my stomach.
Good luck, I HIGHLY recommend the spinal.

[bmcneal]

Hi. I'm new to this site, but I had a c-section with our daughter Sophia (12.22.2005) It was an emergency c-section, and they tried 4 times to do the epidural. They thought they had it, but when they started to prep for the operation, apparently they put a cold pack or something on my leg, because I said "Ohh, that's cold!" They said the epidural wasn't working. So they had to put me completely under. I don't know about a spinal, but if we have to have another c-section and it's an option, I think that's what I will be getting. (We hope to have a natural birth with our next baby.)

[willowsmom]

I had a spinal with Willow. I was glad because I didn't have anything staying in my back. Y'know?

[MsElle07]

I've not had a C-section personally, but my experienced friends have said that the spinal is the way to go. There's a risk of the spinal headache with either procedure, but that the spinal works faster, is more reliable, and they thought they recovered more quickly. I would also ask that you not be given any sedatives in the OR -- most women usually are as part of the routine anesthesia, and they're not even asked or told it's going to be used.

[TCMoulton]

Originally Posted by MsElle07

I've not had a C-section personally, but my experienced friends have said that the spinal is the way to go. There's a risk of the spinal headache with either procedure, but that the spinal works faster, is more reliable, and they thought they recovered more quickly. I would also ask that you not be given any sedatives in the OR -- most women usually are as part of the routine anesthesia, and they're not even asked or told it's going to be used.

Personally I have never known anyone who has received a sedative while having a C/S - my C/S was with an epidural and I had no problems. I was able to move myself to my bed about 1 1/2 after my C/S and was walking by morning. I believe that the one benefit to an emidural is that they can continue to dose it after everything is done if necessary for pain management.

[liberal_chick]

I had a combo spinal/epi. They do the epi for pain control over time, but I really couldn't tell that it was helping me at all. I asked them to take it out a day earlier than they usually do and they were so worried that I'd be in a lot of pain afterward, but I wasn't. I'd go spinal.

[roomformore]

I had a spinal and ended up with migraines. This does not happen with everyone though. I've never had an epi, so cannot give you a comparison. I will say though that like pp, I needed no additional pain medication after the birth.

[velcromom]

Personally I have never known anyone who has received a sedative while having a C/S

They did it to me. Didn't even tell me. I was so stoned when I met ds I barely remembered to reach out and try to touch him. If I ever have to have another c/s I will specifically request that they don't give me anything that will make me loopy. They also knocked me out immediately after ds left the OR; I would rather not be put out entirely as long as anesthesia is adequate; I would rather be awake & alert to get my babe in arms as soon as possible. That was why I didn't choose general, after all.

I had a spinal, and needed a whole lot of pain management after it wore off. I had a hard time getting them to give me adequate pain medication.

[wombatclay]

I had a spinal towards the end of my labor, and a combined spinal for my c/s. I would have a spinal (rather than an epi) in the future if (god's forbid) it became necessary.

With the combined spinal they added an additional batch of pain med to the injection to maintain the pain relief longer than a plain spinal would have done...so I had the longer lasting pain coverage that pp mentioned is an option with the epi, but without the epi in my back.

Sadly, the use of a sedative or additional narcotic dissociative (via IV) isn't uncommon prior to surgery. It's often given to relieve anxiety and may not be explicitely mentioned at the time it's given. It's always a good idea to request what you want...if the hospital in question doesn't routinely give a sedative then they'll tell you that, and if they do then they'll know you don't want it.

[minkajane]

I had a spinal for my C/S. I felt absolutely nothing and didn't have a spinal headache afterwards. I also didn't need strong drugs for pain relief. Unfortunately, I had to stay flat on my back in bed with this stupid inflatable things on my legs and my baby in the nursery for about 15 hours. I've heard that the epidural wears off faster, so if I had to have a medically neccessary C/S in the future (my first was NOT!), I would want to talk to an anesthesiologist about how long before I could get up and walk around, eat, etc.

[TCMoulton]

Originally Posted by velcromom

They did it to me. Didn't even tell me. I was so stoned when I met ds I barely remembered to reach out and try to touch him. If I ever have to have another c/s I will specifically request that they don't give me anything that will make me loopy. They also knocked me out immediately after ds left the OR; I would rather not be put out entirely as long as anesthesia is adequate; I would rather be awake & alert to get my babe in arms as soon as possible. That was why I didn't choose general, after all.

I had a spinal, and needed a whole lot of pain management after it wore off. I had a hard time getting them to give me adequate pain medication.

That's terrible. My C/S was at midnight and I was so wired from the excitement of meeting my daughter that I didn't fall asleep until 3 that morning - I watched Food Network all night while my DH snored in his bed across the room!

[hlkm2e]

I preferred the spinal, also. There is a medicine that they can put right into the spinal that works as pain relief for the first 24-36 hours. I couldn't have it because it is a type of ibroprofen and I am allergic, but I have friends that have had it and they said it really worked. Also, if you are prone to vomiting as I am also, tell the anesthesiologist and they can give you naseau medicine prophalactically in your IV. I'm so glad I did that. I got to hold my babe as I left the operating room and feed them in recovery. I didn't wait until I felt sick to ask for it, I knew I would and made them give it to me before it happened.

[minkajane]

Unfortunately, the anti-nausea meds don't work for everybody. The morphine make me SO sick (I guess it's hereditary, morphine makes my mom really sick too) and they gave me all the anti-nausea meds they could, but I still threw up for the first four hours or so after the C/S.

[OnTheFence]

I am going to be honest about my experience and what I have learned from other mothers and nurses through the years. I have had both a spinal and an epidural.

If I had to have another spinal I would just prefer they knock my ass out. My reason is this, my spinal failed and for 75 minutes I felt my first surgical birth. I cannot describe the excrutiating pain I was in, it leaves even me speechless. The thing with a spinal is that it is short acting -- meaning that once they put it in, there is a short period of time it will work -- after that it quits working. Also if they put the spinal in, and it fails -- there are no second chances, there is no redosing, there is no repositioning to make sure you have a solid block. In other words you are screwed if it fails. While it may provide a "denser" block, it may not offer you the best overall pain relief. You are likely to require more medicatoin during and after your surgery as well, especially if they use duramorph. The side effects of duramorph are irritating but can also turn into pain when you have an abdominal wound 5-7inches long.

While an epidural will not provide as dense as a block, meaning you should feel no pain but you can feel tugging and pushing, it can provide longer relief. Also when they put it in, they can wait to make sure that it covers completely and that the block is dense enough. If it moves to one side or the other, they can redose it and also position you to have the block cover that side or area. (I had this happen with no. 2) I could still feel my legs and move them, I could still feel pushing and tugging, but I felt ABSOLUTELY NO PAIN. I can tell you that this was my overall goal since I felt the first one and was drugged to the moon. With an epidural, you can also be redosed on the table should your surgery involve complications or you do begin to feel pain. Remember, with a spinal -- O well, you are screwed -- they will just pump you full of narcotics.

I continued to have my epidural after my cesarean births these last two times. It would intermintently dose it or I could as it was patient controlled. I could move my legs, feel my lower part of my body (had some numbness in the abdominal area and lower back) but I could sit up in bed. Yes, I SAT UP with both of my last births within minutes of being in recovery. I had my epidural left in until the next morning, about 17-18 hours total and before they removed it they dosed it -- so I had like a walking epidural for the next several hours. This is the time I have my cath and IV removed as well and get up for the first time. I can literally say that my cesarean births with an epidural were pain free and that it definitely helped with my overall immediate recovery.

I have to say that with my epidurals, I have chosen not to take any sedative or pre-op drugs (except anti-acid), during the surgery I opt for Zofran for nausea vs Phenegran, I've read that Zofran acts far better for cesareans and does not cause a drug haze. I had Zofran with section 2 but not section 3. After my epidural is pulled, I opt for straight demerol. I can't take morphine and other narcotics don't do the trick.

I want to add something for people to know because most do not. On most maternity floors now, when they give you demerol it is given with phenegran. It is a combo drug. The name of it escapes me. Anyway, they do this because demerol can cause nausea, but an actual nurse told me it also "helps mothers rest" because it makes moms sleepy. I had to specifically request demerol without phenegran and I had to ask everytime to be sure that is what they were bringing me.

[roslyn]

I had to have two spinals. The first one didn't take. I felt the cold liquid when they began swabbing my abdomen and immediately let the nurse know. They had to sit me back up and do it again. The first time it was the anesthesiologist assistant, the second time they called in the anesthesiologist himself.

[Shawnee]

I had an epidural with my first and a spinal with my second. I'd definitely get a spinal if I had to have another c/s (God forbid).

The epidural left me feeling like I had an elephant sitting on my chest for hours, and with a terrible case of akathesia. It was a feeling like I wanted to crawl out of my skin, it was terrible, the worst night of my life. I didn't have my baby with me, and I couldn't have taken care of her anyway I was in such misery.

I talked to the anesthesiologist about this before my second birth, and he said it was much less likely to happen with a spinal. He was right. I felt great (comparitively). It blocked the sensations more completely, I didn't get the shakes nearly as bad, my feeling came back in my legs quickly afterwards, and no akathesia or breathing problems. I had my baby in the recovery room, best of all (but that's another story.)

Shawnee

[MommytoTwo]

Generally speaking, epidurals are used when you are laboring before your c/s - because they take longer to work but they last longer. Then if you go for a c/s they just turn it way way up.

Spinals are used more with scheduled c-sections because they work quicker and dont last as long.

I had an epi with my first after being in labor and a spinal with my 2nd, no labor. It really made no difference to me either way.

[OnTheFence]

Originally Posted by MommytoTwo

Generally speaking, epidurals are used when you are laboring before your c/s - because they take longer to work but they last longer. Then if you go for a c/s they just turn it way way up.

Spinals are used more with scheduled c-sections because they work quicker and dont last as long.

I had an epi with my first after being in labor and a spinal with my 2nd, no labor. It really made no difference to me either way.

Spinals are also cheaper. This is one reason why they use them.
The hospital I am going to does more epidurals for planned csections because its seen as better pain management in the long run.