An epidural anaesthesia is an anaesthetic process in which anaesthetic is delivered through a catheter into a vacant space outside the spinal cord known as the epidural space. There are few things that should be kept in mind like anaesthetic should be preservative- free. Epidural analgesia is helpful in blocking most of the pain of labour. It is also used after caesarean sections to help control postoperative pain. It is to be kept in mind that not to place a woman flat on her back after she has an epidural analgesia because the supine position can bring on low blood pressure. It is very rare that convulsions can result from severe reactions. Epidural is particularly helpful to women with some medical problems as pregnancy induced heart disease, hypertension, and pulmonary disease. It is basically initiated at the mother’s request, provided that the labour is progressing well, or if the woman feels severe pain during early labour.
To prepare for the administration of epidural anaesthesia, the mother should have the method fully explained and sign consent form if asked. After this an intravenous line is inserted, I it is not already in its place. Woman is positioned on her side or may be in a sitting position. She is connected to the blood pressure monitoring machine. The nurse should have few instruments available like epidural insertion equipment, oxygen, additional intravenous fluid, and foetal monitor.
The doctor cleans the area with an antiseptic solution, and then he injects a local anaesthetic to create a small wheal at the L3-4 area and inserts a needle into the epidural space. When it is ascertained that the needle is in the correct place a polythene catheter is threaded through the needle. Now the needle is removed and a test dose is given. If the patient responds in a right manner to the test dose, a full dose is administered. Relief from pain should come up to the level of the umbilicus. This anaesthesia lasts about 40 minutes to two hours, or may be longer as required. If needed additional dose is given through the catheter. Epidural anaesthesia is given in segments in the labour. Small doses are given so that the perineal muscles do not fully relax. To control intra operative pain additional medicine is injected into the epidural space in the case of caesarean deliveries. Side effects of this type of anaesthesia are itching, vomiting, and nausea, treatment of side effects with the appropriate medication can be helpful. Generally the drug causes a very mild skin reaction, but in severe cases drug can cause breathing difficulties and asthma like reactions. Patient can have burning sensation at the site of injection, sometimes skin swelling or some irritations.