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Epidural anaesthesia

Epidural anaesthesia, often referred to as “an epidural”, is an injection in the lower back that numbs the nerves and stops you feeling pain.
Areas that can be numbed by an epidural include the:
chest
abdomen
pelvic area
legs
How an epidural works

During an epidural, an anaesthetist uses a needle to locate an area of the spine known as the epidural space. An anaesthetist is a doctor specially trained to provide pain relief during surgical procedures.
The anaesthetic works by numbing pain nerves as they enter the spine. The extent of the numbness will depend on the type of drug used, and the amount injected. Once the medication has worn off, feeling in the affected areas will return.

When is an epidural used?

An epidural can be used to provide pain relief in a number of different situations including:
during natural childbirth
during an operation, instead of a general anaesthetic (where you are unconscious during the operation)
after surgery that has been carried out under general anaesthetic

This topic focuses mainly on having an epidural during labour and childbirth.
Safety

Epidurals have been routinely used for many years and are widely accepted as an effective method of providing pain relief after surgery, and during labour and childbirth.
However, as with many medical procedures, there are some associated risks that, although small, you should be aware of before deciding whether to have an epidural. Two possible risks include:
puncture of the dura – the dura is the thickest, outermost layer that surrounds the spinal cord and brain; the risk of the dura being punctured is about one in 100
nerve damage – which occurs only very rarely

Effectiveness

Although epidurals are commonly used to provide pain relief, they are not always effective at reducing labour pain. The Obstetric Anaesthetists Association estimate that one in eight women who have an epidural during labour need to use additional methods of pain relief.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Dizziness, light-headedness, or fainting
slow heartbeat
Less common

Chest pain
extremely shallow or slow breathing
fast heartbeat
fever
hallucinations (seeing, feeling, or hearing things that are not there)
mental depression
sleepiness (excessive)
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects.

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