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What are the risks of having an epidural?

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A person may receive an epidural, a sort of regional anesthesia, during delivery or other medical operations. It’s a pain-relieving technique that causes numbness, mainly in the belly and pelvic region. While the surgery is usually without difficulties, some people may develop adverse effects or long-term complications.

An epidural is a type of pain relief that is administered through an injection in the lower back. The drug is a nerve blocker that can help with labor, childbirth, and certain types of surgery. Although epidurals are generally safe, they do come with some risks and adverse effects, including as headaches, pain, and a drop in blood pressure. They may potentially cause consequences such as irreversible nerve damage in very rare cases.

In this post, we’ll look at how an epidural is administered by a healthcare professional, as well as the risks, side effects, and potential issues.

What is an epidural?

labour lady

An epidural is a sort of regional anesthetic that is also known as an epidural block. An anesthetic is a drug that helps to keep a person from feeling pain. A regional anesthetic is a medication that causes numbness in a significant area of the body, such as the lower extremities.

The location of the numbness varies based on the type and placement of the epidural used by the doctor. An epidural for labor, for example, causes a band of numbness to run from the belly button to the upper legs.

The name derives from the location where the drug is injected, which is into the epidural space by a doctor. The space between the dura mater or dural membrane, a thick layer of protecting tissue, and the spinal cord is referred to as this area. By inhibiting the nerves in the spinal cord that would normally send a signal to the brain to register pain, this drug can assist to prevent pain.

In medical operations such as spinal and abdominal surgeries, as well as during labour and delivery, a doctor may consider utilizing an epidural.

How to use an epidural

A catheter is generally used to provide an epidural during labor. A healthcare expert uses a needle to implant a tiny tube into the lower region of the back. The catheter remains in place after the needle is removed, allowing the medicine to be delivered through the tube. During birthing, the individual receiving the epidural will remain awake and attentive, but will experience some loss of feeling and pain in the bottom half of their body.

A local anesthetic is usually used to numb the injection location before the epidural is administered. A local anesthetic is a medication that numbs a specific part of the body. During the injection, you may feel a small amount of pressure or tingling. However, there should be very little pain after the epidural is injected. When the needle is inserted, a person may still feel some pressure.

The anesthetic staff will try to provide pain relief to a woman giving birth for as long as she needs it. They may try to switch to oral pain medications and stop using the epidural catheter after the first 48–72 hours.

However, an epidural is not necessary for everyone, and patients can explore their alternatives with the anesthetic care team. In fact, an epidural may not be appropriate for some people. Individuals with bleeding disorders, those on blood thinners, or those with a history of spine or brain abnormalities may be at risk.

A person may obtain an epidural through a single needle injection for different treatments, such as surgery or pain relief. People normally experience pain relief within minutes, however adjusting the dose for best pain relief may take some time.

People can also get a combination spinal-epidural using both procedures. This gives the anesthesia staff immediate pain relief that they can sustain with the epidural catheter.

Side effects and risks

Epidurals are quite effective in relieving pain, with just around 1 out of every 100 people requiring additional pain relief during labor. With an epidural, however, there are still some risks and adverse effects to consider.

Epidurals may cause the following side effects:

  • A decrease in blood pressure: Following the administration of an epidural, a person’s blood pressure may drop. This may cause the baby’s heart rate to slow down during birthing. A person may need to drink more water and rest on their side to lessen the chances of this happening.
  • A sore back: There may be some discomfort at the injection location. This type of discomfort normally only lasts a few days.
  • Headache: The epidural injection might occasionally breach the spinal cord’s protective coating. A dural puncture is the medical term for this. This can cause in 2–3% of cases, causing spinal fluid to flow out and causing a headache.
  • Itchiness: Itching is a common side effect of opioid therapy. Other medications might be able to help with the itching.
  • Tingling and numbness in the legs: It’s possible that a person’s legs will feel heavy. Additionally, people may experience leg weakness.
  • Problems with urination: If a person has trouble peeing following an epidural, they may need a urinary catheter.

The following are some less prevalent side effects:

  • epidural abscess
  • osteomyelitis
  • nausea
  • vomiting
  • epidural hematoma
  • sepsis
  • breathing problems
  • fever
  • infection, such as meningitis

An epidural is thought to pose very minimal risk to a baby, according to research. It may, however, raise the risk of a baby’s having short-term changes. These can include the following:

  • tiredness
  • a decrease in muscle tone
  • a decrease in breastfeeding
  • changes in heart rate
  • problems with breathing

Potential long-term complications

Serious complications with epidurals are extremely rare, according to the American College of Obstetricians and Gynecologists. Long-term complications, on the other hand, may include:

  • permanent injury to the spinal cord or nerves
  • breathing problems
  • persistent numbness or tingling

While back pain can cause at the injection site and during labor, an epidural is unlikely to cause long-term back pain. While permanent nerve injury is not impossible, research suggests that it is extremely improbable, as it occurs in fewer than 1 in 240,000 cases.

A link between an epidural and autism in children has also been suggested by several authors. However, research from Canada and Denmark show that epidural exposure and autistic spectrum disorder in children are unrelated.

If a person is concerned about the side effects or risks of an epidural, they should discuss their treatment choices with their healthcare provider.

Conclusion

An epidural is a form of localized anesthetic used to treat pain below the waist. It’s something a doctor might use during surgery or to help with labour and delivery. An epidural is usually administered by a healthcare worker putting a catheter into the back with a needle. Some operations, like as minor surgeries or pain relief, may just require a needle epidural injection.

Headache, soreness, urinary issues, and a drop in blood pressure are all possible adverse effects of an epidural. Long-term problems are exceedingly uncommon, but they can cause irreversible nerve damage and numbness and tingling.

Sources:

  • https://www.nm.org/healthbeat/healthy-tips/9-epidural-myths-debunked
  • https://www.muhealth.org/our-stories/all-about-epidurals-safe-pain-management-option-during-labor
  • https://www.nigms.nih.gov/education/fact-sheets/Pages/anesthesia.aspx
  • https://www.medicalnewstoday.com/articles/epidural-side-effects
  • https://www.med.unc.edu/anesthesiology/patients/childbirth-1/
  • https://www.bcm.edu/healthcare/specialties/anesthesia/epidural-analgesia
  • https://www.radiologyinfo.org/en/info/epidural
  • https://www.ucsfhealth.org/treatments/epidural-injections
  • https://www.nhs.uk/conditions/epidural/
  • https://www.asahq.org/madeforthismoment/pain-management/techniques/epidural/
  • https://www.ncbi.nlm.nih.gov/books/NBK542219/