Most women, when they hear the term epidural anaesthesia, think of alleviating pregnancy and childbirth pains. Fewer people are aware of the use of this procedure in gynaecological surgery, and there is a lasting way to relieve this type of pain in patients with tumours.
There are two forms of analgesia that are very common nowadays. The mechanism of procedure to reduce the childbirth pains is different from, for example, the procedure used in orthopaedic surgery.
We are talking about so-called near spinal anaesthesia (EDA), which is given by the anaesthetist between the vertebrae, but not into the spinal cord, but next to the spinal cord bag. This is where a small diameter cannula is inserted through which the analgesic is administered every 1-1.5 hours. In this case, it is also possible to move, go to the toilet, sit up, the pregnant person can walk in the room.
- This procedure can help pregnant women during the mid-term, so the mother also feels the labour and pushing pains, though the latter in a lesser degree.
- Women do not get tired of pain, so they can work together more effectively in the pushing phase.
- It relaxes the perineum muscles.
- No additional local anaesthesia is required, for example during episiotomy.
- The blood pressure lowering effect is also an advantage in some cases.
We are basically talking about a proven, standardized method so there are no major disadvantages.
- Giving it too early, upon labour, can slow down the birth giving.
- It can cause a drop in blood pressure, which can have a negative effect.
- If the analgesic enters the spinal cord, it can cause headache.
When not applicable?
- In case of coagulation disorder, severe spinal disease.
- In case of severe bleeding during childbirth.
- In case of foetal heart tone deviation.
Author: Balázs Anga-Kis MD