Epidural efficacy question!

  1. Okay, let's preface this with my saying that I'm an NICU nurse, not L&D!

    I attended a c-section delivery and the mother of the baby had recieved an epidural prior to the delivery attempt. When she was being cut, she screamed out in pain and all of the staff on my side of the drape gave each other a "look" as she recieved more anesthesia. Would someone tell me what happened there?

    Is it common for mothers to feel anything after they've had an epidural? I've never had a baby, so I have no personal experience in this area. Even after they gave her more anesthesia, she continued to moan and seemed to be uncomfortable. Was she just feeling the pressure of the delivery, or are you not supposed to feel anything at all?

    I had attended 3 c-sections in nursing school, but they were all adequately anesthetized. Anyone?
    Last edit by NICU_Nurse on Aug 14, '03
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  2. 7 Comments

  3. by   Nienor
    I'm not a nurse, just highly interested in babies and childbirth and lurk daily in this forum. I'm someday entertaining the idea of going to school for Nursing and trying to work in PP - just haven't made my mind up yet. Anyhoo, I wanted to add my epidural didn't work fully during my cesarean section either and I was given several additional doses. I believe the anesthetist said he hated "one-sided blocks." I was not put asleep for the surgery either. I have since had contact with over a dozen women who've had the same or similar problems. So I guess, what I'm saying, is I'm curious too! Thanks for your patience, and thanks for letting me lurk!

    Angie
  4. by   nrsnan_1
    While is doesn't happen often, I have seen poor results from epidural anesthesia for sections. I am an OB nurse of 15 years and can remember somewhere around 10 sections where the mother was not fully numb. Most of the time the anesthesiologist or CRNA will give the mother some medication that causes amnesia, such as versed. She may or may not remember feeling it. For those who do remember, it is a traumatizing experience as it is for those witnessing it. Makes my toes curl.
  5. by   OB/GYN NP
    I have seen a few cases such as this myself. It's the anesthetist's responsiblity to ensure that the patient is well-anesthietized before the draping begins. They usually have to perform an assessment of the level of anesthesia with a pin before the patient is draped. Sounds llike maybe someone didn't do this? A mom commonly will still feel pressure, especially when the baby's head is pushed (or pulled) out, but shouldn't feel sharp pain with the incision. Like nrsnan, my toes are curling...
  6. by   Berta
    My epidural didn't take/work or whatever. Luckily, I had my daughter by vag.
    I have no clue what the person who did the epidural did, but obviously it wasn't right. He made 4 attemps. On the fourth attempt, I begged him to stop because the pain in my back was worse than the contractions. Even the nurse yelled at him to stop. In addition, on one stick, he must have hit a nerve because my leg start jumping like crazy. No, it wasn't the normal shakes from childbirth, he hit something.
    God love that nurse. She was also the one who delivered my daughter. The doctor was busy. UGH
    The kicker was, it was documented by the anesthologist that the epidural was in and working properly. The doc showed up to deliver the placenta and stich up my tear.When I said ouch I can feel that, he say "no you can't, you have an epidural." Both the nurse and I yelled at him at that point. Never again will I have an epidural....
    Had my 2nd daughter without anything. Was a walk in the park compared to the pain from the epidural.
    I shutter to think of having a c section and feeling it.
  7. by   SmilingBluEyes
    UMMM-----------------------boy does this make me mad!

    They are SUPPOSED TO TEST THE SITE for ablity to feel pain PRIOR TO STARTING THE CUT!!!!!!!!!!!!!!!!!!!!!!!

    This, to me, is malpractice. AND IF it's an EMERGENCY situation, they STILL can TEST her sense of touch/pain PRIOR to cutting. If she can feel, she can have a general if it's emergent. Either way, it's wrong to start cutting someone prior to knowing she is numb or not. I have NEVER seen this where I work.
    Seems purty WRONG to me....


    (just an L and D nurse here, not CRNA/MDA).
    Last edit by SmilingBluEyes on Aug 14, '03
  8. by   June55Baby
    Almost 25 years ago when my twin daughters were born by emergency c-section, I had general anesthesia, but I felt the initial incision. I remember thinking, "Oh, my goodness I can feel this", but not really caring. It was the same feeing you have when you cut your finger with a knife... that burning pain.

    I also remebered the neonatologist's voice pager going off paging him to the ER and I heard my babies crying. After I awoke I asked my hisband if the neonatologist left our babies and went to the ER AND I told him I heard the babies cryig and I felt them cutting me as well. My husband, physician and the nursing staff were amazed at everything I recalled while I was supposedly anethesized!

    Three years later I delivered my term son by planned repeat c -section using an epidural. That time I only felt the pulling and tugging of his birth.

    General anesthesia is not fail proof!
  9. by   SmilingBluEyes
    Good point June, but nowadays with spinal and epidural anesthesia being the PRIMARY way to anethesize a patient for csection...e.g. the patient is ALERT AND ORIENTED, there is NO excuse to proceed where she can feel pain-------you are right General is not 100% but I have yet to talk to a patient who remembered anything, let alone being cut. It's better than proceeding with surgery on a totally alert/oriented person *in pain* in my book.

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