Negative effects from epidurals - Page 3

[JanB]

I turned up some information on entonox (aka nitrous oxide) in labor:

http://www.medscape.com/medline/abstract/15321078
(International Journal of Obstetric Anesthesia. 2000; 9(4):270-2)

We report the occurrence of severe hypoxaemic episodes associated with the use of Entonox in labour, in an otherwise healthy woman. These did not occur when the parturient breathed room air during contractions and did not recur when epidural analgesia was established. Possible mechanisms of arterial desaturation associated with the use of Entonox in labour are discussed.

http://www.medscape.com/medline/abstract/8311209
[Anesthesia. 1994; 49(1):32-4]

The arterial oxygen saturation of 40 mothers in the first stage of labour was monitored using pulse oximetry. Half the mothers received epidural analgesia and the rest inhaled Entonox for pain relief. Eight mothers in the Entonox group and six in the epidural group had at least one episode of significant hypoxia (saturation < 90%). There was little difference in the number of hypoxic episodes experienced by either group (29 in the Entonox and 21 in the epidural) although their mean duration and severity was greater in the Entonox group. Women in labour who inhale Entonox have an appreciable incidence of arterial desaturation. Epidural analgesia reduces the severity of hypoxic episodes although it does not eliminate them.

[pigpokey]

Originally Posted by roxyrox

In home birth here you have the same options (well we dial 999 here ). Honestly since your post I have been googling and I cannot find anything negative on using entonox in labour for babies (for mothers it can sometimes make them feel sick/woozy but for babies, I can't find anything bad about it). There does seem to be a lot of studies saying it has no effect on babies though. I think it can't hurt to try if you are really struggling. I didn't particulary like it personally but I have several friends who swear by it!

From http://www.midwiferytoday.com/articl...gsinlabour.asp :

In a well-designed case control study at the Karolinska Institute in Stockholm in 1990, researchers compared children exposed to pain-relieving drugs in labour with those who were not exposed and discovered an increased risk of drug addiction later in life (Jacobson et al., 1990). In 1988 they showed that when nitrous oxide was given to the mother the child was five and one-half times more likely to become an amphetamine addict than a brother or sister born to the same parents. In their paper in the British Medical Journal(1990), patients who had died from opiate addiction were compared with brothers and sisters; the researchers found that if the mothers had been given opiates or barbiturates or larger doses of nitrous oxide, the risk to the child of opiate addiction in later life was increased 4.7 times. In a further study, researchers discovered that the risk of drug addiction was related to the hospital in which they were born. In other words, the likelihood of a child developing drug addiction in later life depended on the labour ward policies of the hospital the mother chose for the birth, and I quote: "For the amphetamine addicts, hospital of birth was found to be an important risk factor even after controlling for residential area" (Nyberg, 1993). Jacobson and Nyberg’s research suggests that the use of opiates, barbiturates and nitrous oxide in labour causes imprinting in the babies, and we are now reaping the whirlwind.

[Jimibell]

Originally Posted by MommytoHHH

My water had broken and I had been in labor for a very long time and was progressing at the rate of well, molasses in january. I was in extreme pain - I'm not sure what was going on down there, but OMG it hurt like the devil. I'm wondering if she was hooked up on my pelvic bone or something. I felt like my bones down there were being shattered with every contraction - every 1.5-2 minutes. I was exhausted and having a hard time maintaining my composure. ...........

I'll also still try to go med-free next time around.

I find it interesting that you felt the need to maintain your composure......for next time around, if you want to go natural, forget about your composure, give yourself over to the contractions and maybe it won't be as painful.....in other words, I think letting go, losing all composure, yelling, moaning, etc are actually great pain relief mechanisms.....

[cfiddlinmama]

I think your posts on the intrathecal (sp?) are very interesting, MaxMama. I have two friends who received them during labor. One of them had a horrible spinal headache and had to receive a blood patch. (I sat with her in the ER for about 8 hrs : ) My other friend (I was at the birth) needed it (due to a pelvic injury), and the anesthesiologist said that it was the same medication as an epidural - just one dose and you don't leave the catheter in place. It was in Montana, though. Maybe they are just that behind there?

[Quindin]

My 3rd baby was the only one born in an American hospital.
I was stupid enough to let them convince me to have an Epi. They were bullying me in so many levels though - and it is hard to fight for what ou had planned when in pain

The birth itself went as smoothly as it could have, but I am 100% sure that if I had not given birth with no meds before, I would NOT have been able to push on my own! It was a very weird and scary feeling not really having full control and knowledge of my own body, specially during labor!

To top it all, I had HORRIBLE, HORRIBLE, HORRIBLE back pains FOR 2 MONTHS after the epi!! Actually, I could barely walk for the first week because the pain was so bad! Compared to my first med-free births when I felt normal 48 hours later, that was very scary!

My baby did not have any side effects from the Epi luckily, but I would like to STRONGLY recommend AGAINST epis to anybody here - PLEASE!!

[maxmama]

Originally Posted by cfiddlinmama

I think your posts on the intrathecal (sp?) are very interesting, MaxMama. I have two friends who received them during labor. One of them had a horrible spinal headache and had to receive a blood patch. (I sat with her in the ER for about 8 hrs : ) My other friend (I was at the birth) needed it (due to a pelvic injury), and the anesthesiologist said that it was the same medication as an epidural - just one dose and you don't leave the catheter in place. It was in Montana, though. Maybe they are just that behind there?

There is a difference in where the medication goes for an intrathecal v. an epidural. With an epidural, the meds go into a potential space with a lot of blood vessels above the covering (dura) of the spinal canal. They diffuse much more gradually, which is also why it takes so much longer to get coverage with an epidural. A properly-placed epidural will NOT lead to a spinal headache.

A spinal, on the other hand, places the meds through the dura, into the fluid of the spinal canal. It's not more dangerous (in fact, it's technically easier), but you do get a more profound BP drop, so the meds are usually mixed with pressors to counteract that, and the block is generally more complete and, of course, not adjustable.

The meds *are* the same, but the placement of them is very different, and so are the effects, both for mom and the baby. The proportion of meds is also often a little different for spinals v. epidurals.

Personally, I've had both (both for sections without labor -- whole other story), and there's a HUGE difference to how I felt physically. Both were "surgical blocks", but with the epidural I could move my legs throughout surgery (though I had no pain); with the spinal it was a pretty profound motor block (again, no pain). It seemed that pushing with a spinal would be pretty damn hard, since I couldn't move my toes.

I don't think anesthesiologists need to be on site after the placement of a spinal, though, whereas they do for an epidural. This would definitely be a consideration for a hospital that doesn't have 24 hour anesthesia in house (which is many rural and small hospitals).