Painless delivery

The most suitable method of anaesthesia

during labour and delivery is epidural
or peridural anaesthesia or pain relief.
The anaesthetist injects pain-relieving
medication through a small tube in the
back. An anaesthetist is a specialist
doctor having knowledge and experience
in providing all types of pain relief to
patients in the operation room, but he
is also an expert in pain relief during a
delivery.

Epidural
anaesthesia

The epidural
After placing an infusion, you have to lie
on your side or bend forward slightly from
the waist. After disinfecting, you get a
small injection with a local painkiller.
With a special needle the anaesthetist
locates the epidural space. He is very
careful to avoid a perforation of the
membrane surrounding the spinal cord.
Therefore, it is important that you lie or
sit still as long as you are asked to do so.
If the membrane surrounding the spinal
cord is hit by accident, you may have
a headache the next day. This seldom
occurs and we can treat this headache.
When the needle is in the right place, the
anaesthetist puts a fine tube near the
nerves, which conduct the pain of the
contractions. Once the tube is placed,
a tight bandage is applied. After testing
the proper working, a painkilling product
is injected. It may take up to 15 minutes

before you are completely free of pain.

While the effect slowly increases, your
blood pressure is checked regularly. We
check whether the epidural anaesthesia
works well. Insufficient anaesthesia
occurs, but can usually be remedied.
During the progress of labour, we can
repeat the injection through the tube or
use a pump, which continuously administers small quantities of painkiller. If
this is not sufficient, you can get an additional dose of pain medication by pushing the button of the pump.
Epidural analgesia is meant to take away
the pain but maintain the feeling of the
contractions. This means that at the end
of labour you still feel when the contractions get stronger, so that you can also
push for the delivery.

Is an epidural possible for every

delivery?
An epidural is not possible in case
of clotting disturbances, a local skin
infection near the puncture site or an
allergy for painkillers. Back problems
such as scoliosis or disk hernia can make
the placing more difficult but do not rule
it out. After certain back operations, it
may be impossible to apply an epidural.

When do you choose an

epidural?
The anaesthesia ward is at your disposal
24/24. After a call a skilled anaesthetist
can relief the pain within 30 minutes. In
principle, an epidural is possible at any
time. but if your gynaecologist expects
a long labour or a difficult delivery, and
certainly in case of induced labour, he
will advise you to use an epidural in
time, even if the contractions are not too
painful at that moment.
In case of a completely spontaneous
delivery, we also advise you not to
postpone the decision for an epidural
too long. Towards the end of labour, it
becomes more difficult to apply and the
benefit of the painkilling effect is less
long.
During the last stage of labour, we can
inject a small quantity of painkiller
directly in the membrane with fluid,
which surrounds the spinal cord. This is
done with a very thin needle, so that the
risk of having a headache is very small.
We do not call it epidural anaesthesia
but spinal anaesthetic. This technique
is also often used in case of a caesarean
section. If you are at the point of giving
birth, epidural anaesthesia is no longer
applied because it would not be effective
in time.

What are the side effects of

epidural anaesthesia?
A drop in blood pressure: this can be
compensated by an infusion or with
medication.
Numb feeling in the legs and heavy
legs, you may not leave the bed
during the anaesthesia.
Backache: a few days pressure pain
near the puncture site. Long lasting
backache is not caused by the
epidural, but can be a result of the
pregnancy.
Very small risk of a headache (see
above), which can be treated
successfully.

What are the advantages of an

epidural?
It reduces the stress of labour and
gives you the comfort of pain relief,
which is beneficial for both you and
your baby.
It allows you to rest between labour
and be better prepared for the
delivery.
There is no risk for the baby.

Have you had an epidural before? If

so, with good result?
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Did you attend the information

evening for pregnant women?
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Permission
anaesthesia

for

epidural

The patient
I confirm that I was informed about the
advantages and possible side effects and
complications of epidural anaesthesia.
I give the doctors of the anaesthesia
team permission to apply an epidural
anaesthesia.

Name:...............................................
Do you have a deviation of the spinal
column?
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Do you take certain medicines? Which

ones? Did you take any aspirin containing
medication last week?
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Are you allergic to certain

medicines?
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Further information can be obtained at

the prenatal information session, each
third Monday of the month.
Appointments to consult an anaesthetist
about epidural anaesthesia can be made
through the anaesthesia administration
office: telephone 03 443 36 13.
More information at
www.anesthesie-augustinus.be.