CHILDBIRTH & ANESTHESIA
Printer FriendlyADVANTAGES AND DISADVANTAGES OF EPIDURAL ANESTHESIA
Epidural anesthesia allows continual highly effective
relief of labor pain, using only small amounts of medication deposited
directly on the spinal nerves. With proper medication combinations and dose
adjustments this pain relief can be achieved, optimally without losing the
ability to control movement in any part of the body.
In some instances, however, variable reduction in strength or coordination
of the legs does occur as a side effect. Most importantly, epidural
anesthesia provides clearly superior pain relief, while having little of the
sedating side effects that limit the use of the intravenous pain medications
that were discussed above.
Also, if cesarean section becomes necessary, the epidural catheter that is
already in place can be used to provide anesthetic for the cesarean delivery
while the patient remains awake and comfortable. Disadvantages of epidural
anesthesia include its potential for contributing to uncommon minor
complications such as:
• Persistent positional headache afterwards, that
occasionally requires additional treatment for rapid resolution
• Incomplete epidural nerve block allowing "patches" of discomfort during
labor (sometimes requiring replacement of the catheter)
• Low back discomfort at the location of the needle placement that is
usually short lived and always is self limited.
A potentially more serious complication is excessive
lowering of the patient's blood pressure that sometimes occurs immediately
after the placement of the epidural. Fortunately, this side effect of
epidural anesthesia can be avoided in most instances, and is remedied
quickly and easily by the vigilant anesthesiologist.
In all other instances, very serious complications such as infection or
bleeding into the confined epidural space, both of which could cause
neurologic injury, have been reported but are extremely rare in the healthy
obstetrical population.