Epidural vs. Spinal Anesthesia for Labor - page 2

Hi everyone, I was wondering if anyone could help me out on understanding the differences between using an epidural vs. a spinal (sub arachnoid) for labor and delivery pain. I understand how... Read More

  1. by   kmchugh
    Quote from colleen10
    I also don't quite understand how much "feeling" a woman is left with. My book says that with an epidural she will not feel pain from labor contractions, but will have pain at birth but that she won't feel the urge to push however I was observing during a labor where mom had an epidural and she could feel contractions and push with them.
    By the way, much of what you are writing about here deals more with the amount and type of local anesthetic used, rather than any real difference between spinal or epidural anesthestia. When I do epidurals for labor, I generally aim for complete pain management. If the mom can feel the pressure of the contraction without hurting, fine. But I can (and have) administered enough medication to provide complete sensory blockade. Meaning mom doesn't feel anything below the level of the epidural.

    And your book is wrong. My goal with epidurals is to keep mom pain free throughout labor AND delivery, while leaving her able to push. We can do that.

    KM
  2. by   Altra
    KMchugh, thanks so much for the info -- I have a much greater understanding now. I haven't had my OB rotation yet, but I did have epidural anesthesia when I had my daughter, and your explanation matches my experience exactly. Nice to understand some of the science behind it now.
  3. by   BETSRN
    Nice explanation, Kevin. However, I don't think the nurse midwife was necessarily suggesting that she could achieve pain control for an incision. She was talking about the use of breathing and relaxation for labor pain. often proper breathing and relaxation techniques is all a woman needs. :hatparty: Having had two children: one without any meds or IV, I can definitely say that I really had little pain at all.

    As a CRNA, it is your job to alliviate pain, especially surgical pain. There is a difference.
  4. by   kmchugh
    Quote from BETSRN
    Nice explanation, Kevin. However, I don't think the nurse midwife was necessarily suggesting that she could achieve pain control for an incision. She was talking about the use of breathing and relaxation for labor pain. often proper breathing and relaxation techniques is all a woman needs. :hatparty: Having had two children: one without any meds or IV, I can definitely say that I really had little pain at all.

    As a CRNA, it is your job to alliviate pain, especially surgical pain. There is a difference.
    Bets

    Are you really saying that "because I did it, you can too?" Since you have had children, you know what the pain of labor is, and any woman who can't withstand it like a "real woman," like you did, is a whimp? Define "often."

    As close to a quote as I can recall: "I can, with breathing and concentration techniques, achieve the same level of pain control with my patients that you get from epidural anesthesia." Not true. For many patients, all the breathing and concentrating in the world will not alleviate the pain many women feel during labor. The last time I checked, something like 75% of women having babies at our hospital did so with epidural anesthesia.

    Remember that pain is a subjective experience. I know that there are women who have children with little or no pain, with no medical intervention whatsoever. I think that's fine, and if you did it that way, great. However, there are other women for whom the pain of labor is intolerable, and attitudes such as "I did it without medications, why can't you?" are counterproductive and harmful to our patients.

    Again, it's not my job to sell anybody anything. By the same token, its not your job to shame them into your way of thinking. Give the patient the facts, unsullied by preconceived notions, yours or mine, then let the patient decide.

    KM
    Last edit by kmchugh on Feb 19, '04
  5. by   BETSRN
    It's not my job to 'sell" anyone anything either. I was stating my opinion,also. Nowhere did I say that one was a "wimp" for choosig epidural anesthesia.I work at a hospital with 2/7 anesthesia and we have a much lower epidural rate than you do: nothing wrong with either. Of course, pain is subjective, we both know that. Working with a laoring woman as I do, I know that not all women need or want any type of anesthesia. If they do, fine, if not, that's fine too. You and I are from two different ends of the spectrum and we are both patient advocates. There is o reason to throw stones and challenge. The original question that the student asked has been answered. You have never had kids and you never will be able to have any kind of appreciation for that. I can never have any appreciation for working with anesthesia because it is not my field of expertise. At no time did I say anywhere "I could do it without mes, why can't you?" Why the defensive response to my post?
  6. by   colleen10
    I just wanted to say I really appreciate everyone's input and Kevins great explaination. I was really quite disappointed that my book felt that epidurals and spinals only deserved about a half a page each. The information that they did have was quite contradictory compared to what has been explained here and also to other references of them in the same book.

    I would never look down upon a woman who used anything for pain management, in fact I am glad to have had the experience of helping a woman with an epidural labor because I feel that when I have a child, that will be the way I go.

    Thanks much, Col

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