Risks of Epidurals and Spinals - Mothering Forums
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#1 of 13 Old 04-17-2004, 11:55 AM - Thread Starter
 
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I was reading another thread and a couple of posters made mention of the risks of getting spinals/epidurals for c-sections. I would love more info on the subject as I am facing a scheduled section at the end of May. I grok the paralysis risk, and I've heard about spinal headaches. Can anyone elaborate on the issue for me? Would it be better to ask for general anesthesia? Would that make me more groggy afterwards??

Wanting very much to make the best choices here.

Thanks!!!!
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#2 of 13 Old 04-17-2004, 12:02 PM
 
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Quote:
Originally posted by AnaNicole
I was reading another thread and a couple of posters made mention of the risks of getting spinals/epidurals for c-sections. I would love more info on the subject as I am facing a scheduled section at the end of May. I grok the paralysis risk, and I've heard about spinal headaches. Can anyone elaborate on the issue for me? Would it be better to ask for general anesthesia? Would that make me more groggy afterwards??

Wanting very much to make the best choices here.

Thanks!!!!
GA is dangerous and carries more risks than a spinal or epidural. You will also have to be seperated from your baby until you are fully awake and alert from the GA.

I will try and find the pros and cons of each. I had a spinal the first time and chose an epidural the second time. I also had the epi cath left in and had a like a "walking" epidural afterwards that way I didnt have to take any meds that messed with my mind.

Kim
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#3 of 13 Old 04-17-2004, 12:07 PM
 
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I had a spinal puncture as a result of my epidura. Was hospitalized for 6 days after my normal vaginal birth BUT I could nurse laying down if someone held my baby on top of me and I did not have to go without food/drink as you do for longer after having general. And it had minimal if any effect on my bebe which is the most important.
I had to have 2 blood patches to correct the puncture- where they draw blood out of your arm and pump it into your back through a catheter. Painful, and it failed the first time so it was repeated. Failed the second time too and I was sent home and told to lay perfectly flat, a little inverted until it healed ( about 10 days).
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#4 of 13 Old 04-17-2004, 12:11 PM
 
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it depends on the exact medication used. The terms "spinal" and "epidural" only refer to the method of injecting the drugs, not the drugs themselves.

You can request the patient info sheet from your doc or hospital, that would have all known risks listed. Or at least find out what drugs are in the epidural or spinal and look it up on the web.

general anasthesia would carry greater risks to you and your baby. Epidural will wear off faster, and I was told it carries the least amount of possible problems. I had a spinal with my c/s, it was straight morphine because of the emergency situation. Took five hours to wear off before I was allowed to hold my baby.
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#5 of 13 Old 04-17-2004, 12:12 PM
 
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This is not an "informational" post, I just want to try to help you feel better and alleviate some of your fears.

I had an epidural (I think??? maybe it was a spinal??) for my cesarean with ds. To be honest, I was glad it was an emergency and I didn't know about it in advance, because I would have worried needlessly about this procedure... I'm so freaked out about needles, but really, it wasn't a big deal. It went in easily, started very, very quickly, gave me total numbness where it should have, wore off in the right period of time afterward, and had no side effects. Even though there *are* side effects, and I don't think we should take these procedures lightly, for a scheduled cesarean, you're going to have a well-rested, unhurried dr. doing it, and I'm sure she/he will do a good job.

I'm trying to remember why a spinal is preferrable to an epidural in a scheduled cesarean (I've read/been told it is)... anyone?

I would *not* do GA. The risks are much higher, and you will miss out on the birth of your baby. (Oh yeah, I was totally "there" and lucid when my son came out, and it was amazing and emotional and wonderful, and I wouldn't have missed it for the world!)
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#6 of 13 Old 04-17-2004, 12:20 PM
 
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a spinal is a one time injection with no catheter, is faster and stronger

an epidural has less risk of spinal headache ( yeah right, not in my case!) and can be left in place and last longer if needed
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#7 of 13 Old 04-18-2004, 10:31 AM - Thread Starter
 
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Thanks for all the responses so quickly! I was never seriously considering GA for so many reasons, but I kept reading posts about the risks of other forms of anesthesia and well, had to know more. This is all new territory for me!

Since I'm allergic to morphine I would guess they'll use Demerol on me but who knows about whether I'll get an Epi or a spinal. Whatever happens, I absolutely love my doctor and have met some of the L&D staff (went in last night and will return tonight for a steroid shot). THEY are amazing. The hospital is pretty progressive (it's St. Vincent's in Santa Fe, where the nurses stood up against circumcision a few years ago).

But always good to walk through those doors armed with as much info as possible. THANKS!
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#8 of 13 Old 04-18-2004, 10:36 AM
 
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The above posts refer to risks to the mother.

There are risks to the baby as well. An epidural does affect the nervous system of the baby (research is scanty [no funding, no duh]). The drug is passed throught the placental filter.

The longer the epi is in tho, the worse the risk. So, if you are just having one put in, say 15 or so mins before your planned c-sec, the baby would be less affected than if it was in for hours as most moms today use them, for pain relief.

The effect on the baby's nervous system can mess with their nursing abilitiees (root, latch properly, suck, swallow, breathe). This can take up to a month to wear off. And women today wonder why they "can't nurse!"

Just for the record, an anecdote. My first was an unscheduled c-sec. The epi was in for less than half an hour before my dd was delivered of me. She nursed like a champ from the start. After the birth, I was given Dilaudid and it had no effect on her nursing abilities either.

Q) What is Dilaudid?

A) Dilaudid is an analgesic narcotic with an addiction liability similar to that of morphine. It is apparent within 15 minutes and remains in effect for more than 5 hours. Dilaudid is approximately 8 times more potent on a milligram basis than morphine. Often called "drug store heroin" on the streets.

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#9 of 13 Old 04-18-2004, 10:39 AM
 
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When I had my c-section, the dr asked if I wanted a spinal or epi. I chose the spinal mainly because I was afraid of the epi not working. The dr also suggested it because the epidural didnt work on my mother or grandmother. I did have a headache after I had my son, but I really think it was due to low blood sugar and excitment. After I threw up (not fun after a csection) I felt fine. I didnt like the fact that after a spinal I had to lay flat for 6 hours. The spinal did wear off quickly, one hour after birth I could move my feet.
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#10 of 13 Old 04-18-2004, 10:50 AM
 
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I had both at the same time, as I was participating in a clinical trial (as a researcher myself, I could hardly say no, lol). It was a bit painful getting the needle put in, but it lasted such a short time. It was like a strong bee sting. As for the risk of paralysis...it totally depends on who is doing it. I wouldn't let a student mess with my spine, but I have total confidence in an experienced anaesthesiologist in a good hospital.

From a pharmacologists POV, an epidural might be more desirable b/c they can titrate your dose and adjust it as necessary. This is especially nice if there is a history of sensitivies or adverse reactions to certain anaesthetic agents.

A C/S under general is the LAST THING IN THE WORLD you want, believe me. GA is riskier to both you and the baby, and has a much greater effect on the CNS than locals. But of course, why be unconcious during the birth? C/S births can still be a beautiful experience, and you get to hold and nurse your baby right afterwards. You are NOT going to feel good after a GA, your baby will be taken off the nursery (where well-meaning nurses will be doing who-knows-what to them), you'll almost certainly miss out on the bonding period and doubtful you'll be able to nurse right away.

I wouldn't wish a G/A birth on anybody.

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#11 of 13 Old 04-18-2004, 04:27 PM
 
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With general anethesia you are completely under. You have a tube into your trachea and the ventilator breathes for you. You are given a drug to paralyze you and a drug to induce amnesia. You do not want someone to breathe for you, if you can help it in any way.

I had an emegency c-sec and the aneth. on that day was the "spinal" expert. They rolled me over, bam, injected me and she was cutting me a second after I was rolled back over. I saw my uterus. It looked like a deflated dodge ball. They all groaned when I asked to see it, as that is just not done. But I was an intensive care nurse at the time and pretty much insisted. My baby was intubated. The silence was horrifiying. She was extubated before I was stapled back together, and we could be together as my legs came back to life. A very weird feeling to have ones body slowly wake up. Uncomfortable, but not painful.

I did not want an indwelling catheter in my spine for any length of time. So I chose the spinal.

I hope your birth is peaceful and beautiful, no matter what way you chose.
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#12 of 13 Old 04-18-2004, 08:11 PM
 
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Quote:
Originally posted by DaryLLL
The above posts refer to risks to the mother.

There are risks to the baby as well. An epidural does affect the nervous system of the baby (research is scanty [no funding, no duh]). The drug is passed throught the placental filter.

The longer the epi is in tho, the worse the risk. So, if you are just having one put in, say 15 or so mins before your planned c-sec, the baby would be less affected than if it was in for hours as most moms today use them, for pain relief.

I want to say that I had an epidural and my baby was totally uneffected. Most epidurals for planned csections are done fairly close to the time of the delivery (like under 20 min) and there is not much time for it to pass through to the placenta.

There are a lot of advantages to having an epidural for a csection. One is that you can get a longer lasting block such as duramorph or a walking epidural for several hours after the birth for pain relief -- instead of having drugs injected into your veins or by mouth that may make you drowsy or loopy. I was completely alert, and happy as a lark and pain free.
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#13 of 13 Old 04-18-2004, 08:13 PM
 
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Quote:
Originally posted by clewal
When I had my c-section, the dr asked if I wanted a spinal or epi. I chose the spinal mainly because I was afraid of the epi not working. The dr also suggested it because the epidural didnt work on my mother or grandmother. I did have a headache after I had my son, but I really think it was due to low blood sugar and excitment. After I threw up (not fun after a csection) I felt fine. I didnt like the fact that after a spinal I had to lay flat for 6 hours. The spinal did wear off quickly, one hour after birth I could move my feet.

My spinal didnt work, went to high in my chest which they said I couldnt get knocked out because it was so high in my chest. I felt my first csection -- it was an hour and 15 minutes of torture and hell. Also my back is still numb in that spot and its been over 7 years.

Kim
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